In-Theater Management of Vascular Injury: 2 Years of the Balad Vascular Registry

Clouse, W. Darrin; Rasmussen, Todd E.; Peck, Michael A.; Eliason, Jonathan L.; Cox, Margueritte; Bowser, Andrew N.; Jenkins, Donald H.; Smith, David L.; Rich, Norman M.

doi:10.1016/j.jamcollsurg.2007.01.040

Cited by 164 publications

(113 citation statements)

References 23 publications

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“…The Vietnam group has the benefit of long experience with prostheses, while the OIF/OEF group benefits from the availability of more advanced technologies and improvements in treatments for injuries in the combat field. These improvements include changes in body armor; improvements in combat casualty care, including the use of artificial blood and rapid evacuation to combat field hospitals; newer myoelectric/hybrid prosthetic-device technologies; and state-of-the-art rehabilitation techniques [9,[28][29][30]. Improved body armor and protective vests have increased survival rates after blast injuries, resulting in an increase in the survival of more severely injured servicemembers.…”

Section: Discussionmentioning

confidence: 99%

Unilateral upper-limb loss: Satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts

McFarland¹,

Winkler²,

Heinemann³

et al. 2010

JRRD

194

136

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Abstract-Prosthetic use and satisfaction in wounded servicemembers and veterans with unilateral upper-limb loss has not been thoroughly explored. Through a national survey, we enrolled 47 participants from the Vietnam conflict and 50 from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/ OEF) with combat-associated major unilateral upper-limb loss. Upper-limb prosthetic devices were used by 70% of the Vietnam group and 76% of the OIF/OEF group. Mechanical/bodypowered upper-limb devices were favored by the Vietnam group, while a combination of myoelectric/hybrid and mechanical/body-powered devices were favored by the OIF/OEF group. Upper-limb devices were completely abandoned in 30% of the Vietnam and 22% of the OIF/OEF groups. Abandonment was more frequent for transhumeral and more proximal levels (42% of Vietnam and 40% of OIF/OEF) than more distal limb-loss levels. Upper-limb prostheses were rejected because of dissatisfaction with the device by significantly fewer (23%) members of the Vietnam group than the OIF/OEF group (45%) (p < 0.001). Most common reasons for rejection included pain, poor comfort, and lack of functionality. A significant paradigm shift has been noted in the OIF/OEF group, who use a greater number and diversity of upper-limb prostheses than the Vietnam group.

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Section: Discussionmentioning

confidence: 99%

Unilateral upper-limb loss: Satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts

McFarland¹,

Winkler²,

Heinemann³

et al. 2010

JRRD

194

136

View full text Add to dashboard Cite

show abstract

“…Even with these limitations in mind, these two groups give insights into the use of prostheses, reasons for abandonment and satisfaction with prostheses, and services at two distinct times over the lifetime of people with limb loss. Differences found in these two groups may be associated with the time period in their life, but also with differences in attitudes in care, advances in prosthetic device technology, and improvements in treatments for combat-related injuries [17][18]36].…”

Section: Discussionmentioning

confidence: 99%

Unilateral lower-limb loss: Prosthetic device use and functional outcomes in servicemembers from Vietnam war and OIF/OEF conflicts

Gailey

McFarland

Cooper

et al. 2010

JRRD

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Abstract-Rehabilitation goals following major combatassociated limb loss in World War II and the Vietnam war focused on treatment of the injury and a return to civilian life. The goal for Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) servicemembers is to restore function to the greatest possible degree and, if they desire, return them to Active Duty, by providing them with extensive rehabilitation services and a variety of prosthetic devices. Our study determines the usefulness of these diverse types of prosthetic devices for restoring functional capability and documents prosthesis use and satisfaction. We compare servicemembers and veterans with major combat-associated unilateral lower-limb loss: 178 from the Vietnam war and 172 from OIF/OEF conflicts. Of survey participants with unilateral lower-limb loss, 84% of the Vietnam group and 94% of the OIF/OEF group currently use at least one prosthetic device. Reasons for rejection varied by type of device, but common reasons were pain, prosthesis too heavy, and poor fit. Abandonment is infrequent (11% Vietnam group, 4% OIF/OEF group). Future efforts should aim to improve prosthetic-device design, decrease pain, and improve quality of life for these veterans and servicemembers.

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“…These data reflect the immediate efficacy of modern munitions on human tissue; advances in non-surgical resuscitation, even if commenced within minutes of injury, may never be able to address disruption to the large central vessels of the torso and coexisting trauma to the brain, heart or lungs. Notably, the incidence of torso vessel trauma is less in populations with access to body armour 4 ; it is likely that continued advances in vehicle and personal protection will always be of greater value than new surgical techniques or processes of care 19 .…”

Section: Peripheral Vascular Injurymentioning

confidence: 99%

“…Among the recent literature, two papers from US military vascular surgeons summarized their contemporary experiences. Clouse and colleagues 4 reported a 2-year experience from the Balad Vascular Registry, compiled from a database maintained at the Air Force Theatre Hospital north of Baghdad, Iraq. Vascular injury was found in 4·8 per cent of battlewounded casualties presenting to surgical staff, with a central (neck and torso) vascular injury rate of 25 per cent and an overall perioperative mortality rate of 4·3 per cent.…”

Section: Peripheral Vascular Injurymentioning

confidence: 99%

Outcome after vascular trauma in a deployed military trauma system

Stannard

Brown

Benson

et al. 2011

Journal of British Surgery

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In-Theater Management of Vascular Injury: 2 Years of the Balad Vascular Registry

Cited by 164 publications

References 23 publications

Unilateral upper-limb loss: Satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts

Unilateral upper-limb loss: Satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts

Unilateral lower-limb loss: Prosthetic device use and functional outcomes in servicemembers from Vietnam war and OIF/OEF conflicts

Outcome after vascular trauma in a deployed military trauma system

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