Hospital Infection of War Wounds

Miles, A. A.; Schwabacher, Herta; Cunliffe, A. C.; Ross, J. Paterson; Spooner, E. T. C.; Pilcher, Robin; Wright, Joyce

doi:10.1136/bmj.2.4172.855

Cited by 39 publications

(11 citation statements)

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“…Lack of local medical infrastructure and security issues may even necessitate these individuals staying for the duration of their treatment. This situation is reminiscent of the 'open reservoir of pathogenic bacteria' as detailed by Miles et al [19].…”

Section: Infection In Conflict Wounded-evidence From Recent Conflictsmentioning

confidence: 99%

“…They found that infection with A. baumannii strongly correlated with the number of host nation patients being treated both in the intensive care unit and on the wards. He concludes that 'these patients may serve as a reservoir for A. baumannii in the combat support hospital', a sentiment again echoing experiences with early infection control in WW2 [19].…”

Section: Infection In Conflict Wounded-evidence From Recent Conflictsmentioning

confidence: 99%

“…The anaerobic bacteria were thus confirmed as being inoculated at point of injury. Miles et al [19] discarded the belief however that all bacteria found within a wound at a later examination must have been implanted at the time of injury stating that this would: '. .…”

Section: Infection In Conflict Wounded-historical Backgroundmentioning

confidence: 99%

“…During the Second World War (WW2), Miles et al [19] demonstrated the predominance of Gram-positive bacteria in wounds two weeks after injury, and decreased presence at this time of Clostridium species. The anaerobic bacteria were thus confirmed as being inoculated at point of injury.…”

Section: Infection In Conflict Wounded-historical Backgroundmentioning

confidence: 99%

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Infection in conflict wounded

Eardley

Brown

Bonner

et al. 2011

Phil. Trans. R. Soc. B

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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.

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Section: Infection In Conflict Wounded-evidence From Recent Conflictsmentioning

confidence: 99%

Section: Infection In Conflict Wounded-evidence From Recent Conflictsmentioning

confidence: 99%

Section: Infection In Conflict Wounded-historical Backgroundmentioning

confidence: 99%

Section: Infection In Conflict Wounded-historical Backgroundmentioning

confidence: 99%

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Infection in conflict wounded

Eardley

Brown

Bonner

et al. 2011

Phil. Trans. R. Soc. B

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“…Among war wounds in surgical wards, evidence of hospital infection was reported by Miles et al (1940) who emphasized the importance of contact spread as distinct from air-borne infection. Unlike the upper respiratory passages, wounds do not filter the bacteria out of large volumes of -air.…”

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confidence: 99%

Observations on ‘hospital infection’ in a plastic surgery ward

Spooner¹

1941

J. Hyg.

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Over a period of 6 months, wounds and throats in a plastic surgery ward were swabbed. Haemolytic streptococci obtained from them were typed by the late Dr F. Griffith and his staff at the M.E.C. Streptococcal Research Laboratory. 65% or more of the wounds in the ward were found to be infected with Streptococcus pyogenes, but relatively few suffered severe damage as a result of their infection.About a quarter of the cases admitted to the ward acquired streptococcal wound infections while in the ward. Two wound and throat epidemics, one due to type 13 and one to type 4/24 streptococci are described.

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The Transmission of Certain Infections of Respiratory Origin

Buchbinder¹

1942

JAMA

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Hospital Infection of War Wounds

Cited by 39 publications

References 0 publications

Infection in conflict wounded

Infection in conflict wounded

Observations on ‘hospital infection’ in a plastic surgery ward

The Transmission of Certain Infections of Respiratory Origin

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