Challenges in war-related thoracic injury faced by French military surgeons in Afghanistan (2009–2013)

Lesquen, Henri de; Béranger, F.; Berbis, Julie; Boddaert, Guillaume; Poichotte, A.; Pons, François; Avaro, J.-P.

doi:10.1016/j.injury.2016.06.008

Cited by 25 publications

(20 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Certains pays européens tiennent à jour une base de données nationale de traumatologie, mais peu d'études se sont concentrées sur la prise en charge des patients victimes de TTP (8,50,51). Il n'existe à ce jour aucune étude française publiée.…”

Section: Ii-7/ Problématique Et Objectifsunclassified

“…A côté de cette faible incidence, la présence d'un TTP est associée à une mortalité importante, puisqu'elle peut être majorée jusqu'à 2,6 fois par rapport à un traumatisme thoracique fermé (2), avec un risque de décès majeur sur le lieu de l'accident (6). La prise en charge des TTP représente donc un challenge médico-chirurgical pour les équipes préhospitalières et hospitalières de traumatologie (7,8).…”

Section: -Introductionunclassified

See 1 more Smart Citation

Penetrating thoracic injuries: a retrospective analysis from a French military trauma centre

et al. 2019

View full text Add to dashboard Cite

BackgroundPenetrating thoracic injuries (PTIs) is a medicosurgical challenge for civilian and military trauma teams. In civilian European practice, PTIs are most likely due to stab wounds and mostly require a simple chest tube drainage. On the battlefield, combat casualties suffer severe injuries, caused by high-lethality wounding agents.The aim of this study was to analyse and compare the demographics, injury patterns, surgical management and clinical outcomes of civilian and military patients with PTIs.MethodsAll patients with PTIs admitted to a Level I Trauma Centre in France or to Role-2 facilities in war theatres between 1 January 2004 and 31 May 2016 were included. Combat casualties’ data were analysed from Role-2 medical charts. The hospital manages military casualties evacuated from war theatres who had already received primary surgical care, but also civilian patients issued from the Paris area. During the study period, French soldiers were deployed in Afghanistan, in West Africa and in the Sahelo-Saharan band since 2013.Results52 civilian and 17 military patients were included. Main mechanisms of injury were stab wounds for civilian patients, and gunshot wounds and explosive fragments for military casualties. Military patients suffered more severe injuries and needed more thoracotomies. In total, 29 (33%) patients were unstable or in cardiac arrest on admission. Thoracic surgery was performed in 38 (55%) patients (25 thoracotomies and 13 thoracoscopies). Intrahospital mortality was 18.8%.ConclusionWar PTIs are associated with extrathoracic injuries and higher mortality than PTIs in the French civilian area. In order to reduce the mortality of PTIs in combat, our study highlights the need to improve tactical en route care with transfusion capabilities and the deployment of forward surgical units closer to the combatants. In the civilian area, our results indicated that video-assisted thoracoscopic surgery is a reliable diagnostic and therapeutic technique for haemodynamically stable patients.

show abstract

Section: Ii-7/ Problématique Et Objectifsunclassified

Section: -Introductionunclassified

Penetrating thoracic injuries: a retrospective analysis from a French military trauma centre

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The pleura and pericardium are opened, the injured aorta is clamped, and intrathoracic CPR is performed. If the heart resuscitation is successful, emergency procedures should be prepared immediately, and the wounded soldier should be transferred to the operating room for further surgical treatment [ 31 – 34 ].…”

Section: Early Treatments For Wartime Thoracic Injury In Modern Warfamentioning

confidence: 99%

“…2) Wounded soldiers with severe heart contusion. 3) Wounded soldiers with severe tracheal and bronchial injuries [ 34 – 37 ].…”

Section: Early Treatments For Wartime Thoracic Injury In Modern Warfamentioning

confidence: 99%

Chinese expert consensus on echelons treatment of thoracic injury in modern warfare

et al. 2018

View full text Add to dashboard Cite

The emergency treatment of thoracic injuries varies of general conditions and modern warfare. However, there are no unified battlefield treatment guidelines for thoracic injuries in the Chinese People’s Liberation Army (PLA). An expert consensus has been reached based on the epidemiology of thoracic injuries and the concept of battlefield treatment combined with the existing levels of military medical care in modern warfare. Since there are no differences in the specialized treatment for thoracic injuries between general conditions and modern warfare, first aid, emergency treatment, and early treatment of thoracic injuries are introduced separately in three levels in this consensus. At Level I facilities, tension pneumothorax and open pneumothorax are recommended for initial assessment during the first aid stage. Re-evaluation and further treatment for hemothorax, flail chest, and pericardial tamponade are recommended at Level II facilities. At Level III facilities, simple surgical operations such as emergency thoracotomy and debridement surgery for open pneumothorax are recommended. The grading standard for evidence evaluation and recommendation was used to reach this expert consensus.

show abstract

“…In a study examining battle eld fatalities from October 2001 to June 2011, torso hemorrhage accounted for 61.2% of 976 preventable deaths [3]. During war of Iraqi, thoracic injury occurred in 10% of casualties and the related mortality was around 10% [8].…”

Section: Introductionmentioning

confidence: 99%

Single center experience of war-related thoracic injury in Syria

Ulusan

Tunca

Şanlı

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The Syrian civil war caused serious deaths and injuries. Thoracic surgery has shown its effectiveness in this war as it is a war surgery. In this study, we analyzed war related chest trauma patients to describe the profile of chest trauma, determine the predictors’ morbidity and mortality. Methods: From 2012 to 2017, 47 consecutive patients underwent surgical treatment for chest trauma at the Gaziantep University Sahinbey Research and Practice Hospital, in Turkey. The demographic and relevant clinical information were retrospectively collected from the hospital records. Data included mechanism of injury, gender, and age, findings, treatment modality complications, and length of hospital stay, morbidity and mortality. Injuries were classified as penetrating (gunshot or shrapnel wounds) and blunt injuries. Results: The average age of patients was 25.4 years (range, 4 to 43 years) and 40 patients were males (85%). Sadly, 6 patients were under 18 years old. There were 41 patients (%87,2) penetrating and 6 patients (%12,8) blunt injuries. The most penetrating injuries of the chest were caused by shrapnel (61,7%). Eleven patients had already had emergency thoracotomy in another hospital before admission. As multiple diagnoses, there were 50 (45,45%) pneumothorax, hemothorax, or both in patients. However, there were 26 (23,64%) lung contusions in patients. No surgery-related deaths or major morbidity occurred. One patient died 35 days after admission; the causes of death in this patient included bronchobiliary fistula, hypovolemic shock, and sepsis. So, all cases mortality rate was 2,13%. Conclusion : Intervention in thoracic trauma patients is life-saving and satisfying compared to other system injuries. War surgery is a multidisciplinary approach, which is vital.

show abstract

Challenges in war-related thoracic injury faced by French military surgeons in Afghanistan (2009–2013)

Cited by 25 publications

References 21 publications

Penetrating thoracic injuries: a retrospective analysis from a French military trauma centre

Penetrating thoracic injuries: a retrospective analysis from a French military trauma centre

Chinese expert consensus on echelons treatment of thoracic injury in modern warfare

Single center experience of war-related thoracic injury in Syria

Contact Info

Product

Resources

About