Early History of Wound Treatment

Forrest, R D

doi:10.1177/014107688207500310

Cited by 200 publications

(38 citation statements)

References 2 publications

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“…Since ancient times, many different materials have been used to treat wounds in an attempt to stop bleeding, absorb exudates and promote healing, including honey, animal oils or fat, cobwebs, mud, leaves, sphagnum moss, and animal dung [8] . Of these substances, with the exception of honey, none have shown promising results.…”

Section: Discussionmentioning

confidence: 99%

Haemostatic action of a topical foam-based patch (VELSEAL-T) in haemophiliac patients with external bleeding

Dutta

Das

et al. 2020

The Journal of Haemophilia Practice

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AbstractIntroductionHaemophilia is an X-linked congenital bleeding disorder due to deficiency of coagulation factor VIII (in haemophilia A) or factor IX (in haemophilia B) caused by mutations of the respective clotting factor genes. Treatment involves the administration of an appropriate dose of factor concentrate, as soon as possible, in the event of any bleeding episode. In low-resource settings, such as Northeast India, where factor concentrates are not widely available, people with haemophilia (PwH) may bleed profusely even from trivial external injuries, warranting transfusion of blood or blood products. We previously reported on the use of a low cost, foam-based haemostatic patch to treat an external bleed in a single patient. In this study, we investigated its use to treat a range of external injuries in PwH presenting at Assam Medical College and Hospital.MethodOver 24 months, eligible PwH with external injuries attending our haemophilia clinic were treated with a topical haemostatic patch (VELSEAL-T) at the target bleeding site. The time to cessation of bleeding was recorded and the wound sites evaluated after haemostasis to monitor efficacy and safety.ResultsOut of 72 individuals with bleeding disorders who volunteered to participate, 59 cases of external bleeding in 48 PwH were eligible for inclusion in the study. Nine (15.3%) had aberration wounds, 24 (40.7%) cut wounds, 21 (35.6%) tooth and/or gum bleeding and five (8.4%) bleeding from puncture wounds. The average time required for achievement of haemostasis was 9.9 (±4.7) minutes. Aberration wounds required the least amount of time for haemostasis at 7.3 (±4.4) minutes. Cut wounds required a mean time of 8.5 (±2.9) minutes; puncture wounds required 9.0 (±3.1) minutes; gum bleeding required the longest time to achieve haemostasis with a mean of 12.7 (±5.6) minutes.ConclusionThe use of this topical haemostatic patch has been shown to be beneficial in the treatment of external injuries in PwH, and provides a good treatment option in resource-constrained areas. A larger controlled study would be helpful to further investigate its efficacy and safety.

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Section: Discussionmentioning

confidence: 99%

Haemostatic action of a topical foam-based patch (VELSEAL-T) in haemophiliac patients with external bleeding

Dutta

Das

et al. 2020

The Journal of Haemophilia Practice

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“…Care under fire: Care under fire (CUF) is a situation during active combat where both the casualty and the care provider are in danger from enemy fire, may or may not be behind adequate cover and may need to contribute to the firefight. Only 2 medical treatments [6,7] are appropriate during this phase: Tourniquet use for massive hemorrhage and the Recovery position for airway obstruction. If air way obstruction persists, use of nasal air way.…”

Section: Kargil Warmentioning

confidence: 99%

Overview of Management of Combat Casualties in Mountains: Challenges and Improvements

2022

JCBSC

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Combat casualties are those casualties which are due to either direct enemy action or those sustained due to any combat related mission. The grading of the casualty varies from mild to serious to life threatening. The damage gets compounded due to the prevailing conditions and field conditions which make timely evacuation difficult. Management of casualties has to be done maintaining the Golden Hour which becomes challenging due to varied factors ranging from terrain to Op logistics. Especially in mountains where the weather and evacuation channels play a major role. Due to the changing management protocols and rapid advancement in technology, the scenario of managing combat casualties has vastly improved. However, the scope of the present article will be restricted to combat casualty management in mountainous terrain. Recommendations are made for improved modes of casualty care and evacuation. A comprehensive search of the relevant literature was done from major scientific database. Assessment of relevant articles was done and compilation was carried out. Articles were studied from Medline, Google Scholar and Cochrane Library. Online consultation was done with various agencies dealing with casualty care especially in mountainous terrain. Modern Combat casualty evacuation has become immediate and efficient. The ultimate goal of combat care is return of the greatest possible number of soldiers to combat and preservation of life and limb. This with the added change in battle scenario of conventional war which will be fought under nuclear umbrella. Timely administration of medical care by adequately trained personnel and well-equipped medical echelons will go long way in reducing mortality rate.The last few decades Overview of … Brig Poninder and Col Satish.

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“…D ecades of controversy discouraged tourniquet use (Husum et al, 2004;Navein et al, 2003), which had been a hemorrhage control tool for hundreds of years (Forrest, 1982). Two decades of recent evidence; however, show tourniquets to be a safe and effective early intervention for extremity hemorrhage for injured adults in the military (Beekley et al, 2008;Lakstein et al, 2003), civilian care (Kauvar et al, 2018), and for children (Kragh et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Comparison Of Non-clinical Tourniquet Research for Appliance Superiority & Tolerance (CONTRAST)

Picard

O'Dochartaigh²,

Bakal³

et al. 2022

CJEN

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BACKGROUND: Tourniquets are effective tools to manage life-threatening extremity hemorrhage. Commercial devices are recommended over improvised ones; however, mass casualty incidents and austere environments may prevent access to commercial devices. The aim of this review is to systematically search and meta-analyze commercial and improvised tourniquets: arterial occlusion, application speed, and patient tolerance. METHODS: We searched MEDLINE, Embase, CINAHL, Cochrane Library, SPORTDiscus, and ProQuest Dissertations & Theses Global using controlled terms; without date limits. Manikin, animal, and operative studies were excluded. Tourniquet devices were pooled by design and compared. Data regarding provider training and experience, recipient anthropometrics, application site, ease of application, speed, tolerance, and device efficacy were examined. RESULTS: 5169 studies were screened. The 36 included studies were prospective trials on healthy volunteers and published between 2000 and 2021. There were 8205 unique tourniquet applications to 1921 subjects using 23 unique commercial and improvised devices. Median sample size of included studies was 20 (IQR 26) participants, ranging from 1 to 773 participants; and 102 (IQR=152) applications ranging from 20 individual applications to 1546 unique applications. The most commonly assessed outcomes were: effectiveness (n=30), pain (n=18), speed of application (n=13), and amount of mechanical advantage (ex. Windlass turns) required (n=13). Male participants outnumbered females 1,414 to 169, mean age ranged from 21 to 45 years of age. Devices were pooled into 5 categories according to mechanical advantage mechanism: elastic, friction, mechanical, pneumatic, and windlass. Initial hemostasis was achieved in 95% of upper extremity placements (CI=0.89-0.98, p= 0.02), and 88% of mid-thigh applications (CI=0.78-0.94, p>0.01), in both groups pneumatic and mechanical tourniquet devices had the highest rates of success, with friction and elastic devices having the lowest rates of success. Meta-analysis showed that mechanical and pneumatic advantage systems had superior rates of hemostasis, ease of use, and pain tolerance scores. Due to study heterogeneity, we could not determine which devices were the fastest to apply. The overall risk of bias assessment for included studies found the certainty of studies ranged from moderate to critical. CONCLUSION: In pre-clinical studies mechanical and pneumatic advantage systems appear to be the superior tourniquet design. Due to the low certainty of evidence and non-randomizable nature of traumatic injury, pre-clinical tourniquet devices will likely continue to be tested on well volunteers. Adoption of a minimum data set, agreed upon definitions for testable metrics, and a standardized experimental design could improve the comparability and quality of future tourniquet device studies.

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Early History of Wound Treatment

Cited by 200 publications

References 2 publications

Haemostatic action of a topical foam-based patch (VELSEAL-T) in haemophiliac patients with external bleeding

Haemostatic action of a topical foam-based patch (VELSEAL-T) in haemophiliac patients with external bleeding

Overview of Management of Combat Casualties in Mountains: Challenges and Improvements

Comparison Of Non-clinical Tourniquet Research for Appliance Superiority & Tolerance (CONTRAST)

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