War surgery in a Turkish hospital near the border of Syria: An evaluation in terms of critical and intensive care treatment principles

Şimşek, Betül Kocamer; Dokur, Mehmet; Uysal, Erdal; Çalıker, Necdet; Gökçe, Oruç Numan; Deniz, İbrahim Kürşat; Uğur, Murat; Geyik, Murat; Kaya, Mehmet Cemal; Dağlı, Güner

doi:10.5505/tjtes.2016.95525

Cited by 20 publications

(11 citation statements)

References 15 publications

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“…Possibly due to its proximity to conflicts along the Syrian border, several studies highlighted the need for emergency care among Syrian refugees in Turkey when compared to other countries in the region. A study evaluating hospital admissions found the emergency department to be the most commonly used department [57], and gunshot wounds were found to be the most common cause of hospital admission [51], representing 84% [50] and 70% [5] of all admissions of Syrian refugees to the emergency department.…”

Section: Resultsmentioning

confidence: 99%

Assessment of the health needs of Syrian refugees in Lebanon and Syria’s neighboring countries

et al. 2019

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Background Health needs of displaced Syrians in refugee hosting countries have become increasingly complex in light of the protracted Syrian conflict. The primary aim of this study was to identify the primary health needs of displaced Syrians in Iraq, Jordan, Lebanon, Turkey, and Syria. Methods A systematic review was performed using 6 electronic databases, and multiple grey literature sources. Title, abstract, and full text screening were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The target population was Syrian individuals displaced due to conflict in Syria and its neighboring countries. The outcomes of interest were health needs (i.e. health problems that can be addressed by health services), gaps in health services, training, and workforce. Studies on mixed refugee populations and Syrians displaced prior to the conflict were excluded. Results The Lebanon-specific results of the review were validated through two stakeholder roundtable discussions conducted with representatives from primary healthcare centers, non-governmental organizations and humanitarian aid agencies. A total of 63 articles were included in the analysis. Mental health and women’s health were identified as the greatest health needs in the region. The most common health problems were Non-communicable diseases in Jordan, women’s health in Lebanon and mental health in Turkey. Studies addressing gaps in services found the highest gap in general healthcare services, followed by women’s health, mental health, and vaccinations. Sub-optimal training and availability of health workers was also noted particularly in Syria. Results from the stakeholders’ discussions in Lebanon showed communicable diseases, women’s health and mental health as the main health needs of Syrian refugees in Lebanon. Reported barriers to accessing health services included geographical barriers and lack of necessary awareness and education. Conclusion There is a need for an enhanced synchronized approach in Syria’s refugee hosting neighboring countries to reduce the existing gaps in responding to the needs of Syrian refugees, especially in regards to women’s health, mental health, and communicable diseases. This mainly includes training of healthcare workers to ensure a skilled workforce and community-based efforts to overcome barriers to access, including lack of knowledge and awareness about highly prevalent health conditions. Electronic supplementary material The online version of this article (10.1186/s13031-019-0211-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Assessment of the health needs of Syrian refugees in Lebanon and Syria’s neighboring countries

et al. 2019

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“…However, the type of management of the PNI Table 4 Airway soft signs 2 × 2 contingency table. Table 5 Any soft signs 2 × 2 contingency table. shouldn't be determined by the mechanisms of assault or neck zone affected but by the signs and symptoms presented by the patient [3,4,11,18].…”

Section: Discussionmentioning

confidence: 99%

“…Penetrating neck injuries are more likely to occur in highly populated areas where there is more interpersonal violence and more gun and knife crime between young men [3]. Additionally, the rise of global terrorism and continuing wars in the Middle East has perpetuated head and neck injuries in the civilian population leading to elevated morbidity and mortality rates [4,5].…”

Section: Introductionmentioning

confidence: 99%

Value of clinical examination in the assessment of penetrating neck injuries: a retrospective study of diagnostic accuracy test

et al. 2020

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Background: There are many high-volume trauma centers in limited resource environments where a thorough clinical examination of patients may contribute to a more economical, accurate, and widely applicable method of determining the proper management of patients with penetrating neck injuries. The purpose of this study was to validate thorough physical examination as a reliable diagnostic tool in these patients. Methods: We performed an observational retrospective study of a diagnostic accuracy test where we compared clinical findings (symptoms and soft signs on admission of the patient) with the definitive findings according to the gold standard test for each particular situation (selective studies, clinical observation and surgical exploration). The study was conducted at Hospital Occidente Kennedy (HOK) between August 2009 and June 2010. Results: The sample consisted of the clinical records of 207 (n = 207) patients who went to the emergency room for penetrating neck wounds at Hospital Occidente Kennedy (HOK). Of the total sample, 36.2% (n = 75) of patients were considered "asymptomatic" as they didn't present with any soft signs of injury. Vascular soft signs were present in 57% (n = 118) of the patients, soft signs of the airway and the upper gastrointestinal tract were present in 15.9% (n = 33) and 21.3% (n = 44) of the patients respectively. The sensitivity and negative predictive value (NPV) of any soft sign to determine injuries which require surgical repair was 97.4% [CI] [86.5-99.5%] and 98.7% [CI] [92.8-99.8%] respectively, with a range of confidence [CI] of 95%. Conclusions: Our study's main findings suggest that patients with neck injuries and no vascular, airway, or gastrointestinal soft sign can be safely managed with a conservative approach. It is important to emphasize the value of the clinical examination since there are many contexts in the modern world where a considerable amount of the population is afflicted by neck trauma and treated under conditions where technological resources are limited.

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“…Although war surgery's spectrum is broad, surgeons have to deal with two main trauma mechanisms. Most of the injuries are caused by penetrating high velocity projectiles of any sort (BI and SI) or by blasts and burns from explosives like bombs or mines (SI and MI) [2].…”

Section: Pathway and Educationmentioning

confidence: 99%

“…Medical care in low-income countries (LIC) differs a from western medical standards [1]. Compared with civilian trauma in LIC, which is mainly caused by road traffic accidents, the injuries in war zones present different patterns with numerous wounds caused by bullets, mines, and bombs [2,3].…”

Section: Introductionmentioning

confidence: 99%

War surgery in Afghanistan: a model for mass causalities in terror attacks?

Wichlas

Hofmann

Strada³

et al. 2020

International Orthopaedics (SICOT)

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Purpose The aim of the study was to identify solution strategies from a non-governmental (NGO) hospital in a war region for violence-related injuries and to show how high-income countries (HIC) might benefit from this expertise. Methods NGO trauma hospital in Lashkar Gah, Afghanistan. Four hundred eighty-four war victims admitted in a three month period (February 2016–May 2016) were included. Patients´ characteristics were analyzed. Results The mean age was 23.5 years. Four hundred thirty-four (89.9%) were male, and 50 (10.1%) were female. The most common cause of injury was bullet injuries, shell injuries, and mine injuries. The most common injured body region was the lower extremity, upper extremity, and the chest or the face. Apart from surgical wound care and debridements, which were performed on every wound in the operation theatre, laparotomy was the most common surgical procedure, followed by installation of a chest drainage and amputation. Conclusion The surgical expertise and clear pathways outweigh modern infrastructure. In case of a mass casualty incident, fast decision-making with basic diagnostic means in order to take rapid measurements for life-saving therapies could make the difference.

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War surgery in a Turkish hospital near the border of Syria: An evaluation in terms of critical and intensive care treatment principles

Cited by 20 publications

References 15 publications

Assessment of the health needs of Syrian refugees in Lebanon and Syria’s neighboring countries

Assessment of the health needs of Syrian refugees in Lebanon and Syria’s neighboring countries

Value of clinical examination in the assessment of penetrating neck injuries: a retrospective study of diagnostic accuracy test

War surgery in Afghanistan: a model for mass causalities in terror attacks?

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