Bacterial Flora of One Hundred and Twelve Combat Wounds

Kovaric, John J.; Matsumoto, Teruo; Dobek, Arthur S.; Hamit, Harold F.

doi:10.1093/milmed/133.8.622

Cited by 33 publications

(18 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All those with evidence of bacteraemia had strains reported to be resistant to antibiotics. These findings of mixed wound flora, an ultimate predomination by Pseudomonas species and emerging drug resistance corroborated previous anecdotal reports from wounds in injured servicemen [30,31].…”

Section: Infection In Conflict Wounded-historical Backgroundsupporting

confidence: 90%

Infection in conflict wounded

Eardley

Brown

Bonner

et al. 2011

Phil. Trans. R. Soc. B

View full text Add to dashboard Cite

Although mechanisms of modern military wounding may be distinct from those of ancient conflicts, the infectious sequelae of ballistic trauma and the evolving microbial flora of war wounds remain a considerable burden on both the injured combatant and their deployed medical systems. Battlefield surgeons of ancient times favoured suppuration in war wounding and as such Galenic encouragement of pus formation would hinder progress in wound care for centuries. Napoleonic surgeons eventually abandoned this mantra, embracing radical surgical intervention, primarily by amputation, to prevent infection. Later, microscopy enabled identification of microorganisms and characterization of wound flora. Concurrent advances in sanitation and evacuation enabled improved outcomes and establishment of modern military medical systems. Advances in medical doctrine and technology afford those injured in current conflicts with increasing survivability through rapid evacuation, sophisticated resuscitation and timely surgical intervention. Infectious complications in those that do survive, however, are a major concern. Addressing antibiotic use, nosocomial transmission and infectious sequelae are a current clinical management and research priority and will remain so in an era characterized by a massive burden of combat extremity injury. This paper provides a review of infection in combat wounding from a historical setting through to the modern evidence base.

show abstract

Section: Infection In Conflict Wounded-historical Backgroundsupporting

confidence: 90%

Infection in conflict wounded

Eardley

Brown

Bonner

et al. 2011

Phil. Trans. R. Soc. B

View full text Add to dashboard Cite

show abstract

“…In Korea, penicillin and streptomycin were commonly used in wound prophylaxis, but at a risk that only became evident in retrospect, as increasingly resistant bacteria were reported from infected war wounds 3 to 5 days after injury [30,58]. The wars in Korea and Vietnam also demonstrated the tremendous advances in transport and treatment that remain a key strength in today's U.S. military.…”

Section: Historical Perspectivementioning

confidence: 99%

Multidrug-resistant Organisms in Military Wounds from Iraq and Afghanistan

Calhoun

Murray

Manring

2008

Clinical Orthopaedics &Amp; Related Research

160

136

View full text Add to dashboard Cite

Mortality from battlefield wounds has historically declined, thanks to better surgical management, faster transport of casualties, and improved antibiotics. Today, one of the major challenges facing U.S. military caregivers is the presence of multidrug-resistant organisms in orthopaedic extremity wounds. The most frequently identified resistant strains of bacteria are Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter calcoaceticus-baumannii complex. Overuse of broad-spectrum antibiotics may be an important factor in building resistant strains. Acinetobacter infections appear to hospital-acquired and not from an initial colonization of the injury. More research is required to give military physicians the tools they require to reduce the infection rate and defeat multidrug-resistant organisms.

show abstract

“…The decrease in time from wounding to surgical care thanks to rapid evacuation and MASH units was linked to an impressive reduction in the occurrence of gas gangrene; one study of 4900 wounds revealed a 0.08 incidence of gas gangrene and no mortality attributable to it [74]. Antibiotics were commonly used prophylactically, but at a risk that only became evident in retrospect, as increasingly resistant bacteria were reported from infected war wounds 3 to 5 days after injury [86,141]. Physicians made a greater effort to identify bacteria and evaluate outcomes of antibiotic strategies.…”

Section: Infection and Antibioticsmentioning

confidence: 99%

“…All bacteria from blood cultures were resistant to penicillin and streptomycin [136]. The 1968 study of Kovaric et al [86] of 112 cultures identified resistant strains of Enterobacter aerogenes, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli.…”

Section: Infection and Antibioticsmentioning

confidence: 99%

Treatment of War Wounds: A Historical Review

Manring

Hawk

Calhoun

et al. 2009

Clinical Orthopaedics &Amp; Related Research

142

View full text Add to dashboard Cite

The treatment of war wounds is an ancient art, constantly refined to reflect improvements in weapons technology, transportation, antiseptic practices, and surgical techniques. Throughout most of the history of warfare, more soldiers died from disease than combat wounds, and misconceptions regarding the best timing and mode of treatment for injuries often resulted in more harm than good. Since the 19th century, mortality from war wounds steadily decreased as surgeons on all sides of conflicts developed systems for rapidly moving the wounded from the battlefield to frontline hospitals where surgical care is delivered. We review the most important trends in US and Western military trauma management over two centuries, including the shift from primary to delayed closure in wound management, refinement of amputation techniques, advances in evacuation philosophy and technology, the development of antiseptic practices, and the use of antibiotics. We also discuss how the lessons of history are reflected in contemporary US practices in Iraq and Afghanistan.

show abstract

Bacterial Flora of One Hundred and Twelve Combat Wounds

Cited by 33 publications

References 0 publications

Infection in conflict wounded

Infection in conflict wounded

Multidrug-resistant Organisms in Military Wounds from Iraq and Afghanistan

Treatment of War Wounds: A Historical Review

Contact Info

Product

Resources

About