Resuscitation of battle casualties in South Vietnam: experiences at the First Australian Field Hospital

Knight, Rose

doi:10.1016/0300-9572(73)90018-x

Cited by 8 publications

(3 citation statements)

References 36 publications

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“…We identified four literature reviews [6-9], two prospective studies [11,12], twelve retrospective reviews [2-5,10,13-19], seventeen papers with case reports [6,8,20-33], and three commentaries [34-36]. 31 publication contributed patient data on a total of 664 patients.…”

Section: Resultsmentioning

confidence: 99%

“…They also highlight rare complications following high-velocity or low-velocity gunshot injury to the buttock where the bullet or pellet migrates to major veins such as inferior cava vein and hepatic veins [29] or if it reaches the right ventricle of the heart [23], needing a broad range of approaches ranging from open surgery to angioembolization [6,21,22], transjugular extraction of bullet from middle hepatic vein [29], image navigation surgery [33], gluteal surgery [28,32], laparoscopy [24], and laparotomy [6,20,21,25]. …”

Section: Discussionmentioning

confidence: 99%

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Analytical review of 664 cases of penetrating buttock trauma

Lunevičius

Schulte

2011

World J Emerg Surg

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A comprehensive review of data has not yet been provided as penetrating injury to the buttock is not a common condition accounting for 2-3% of all penetrating injuries. The aim of the study is to provide the as yet lacking analytical review of the literature on penetrating trauma to the buttock, with appraisal of characteristics, features, outcomes, and patterns of major injuries. Based on these results we will provide an algorithm. Using a set of terms we searched the databases Pub Med, EMBASE, Cochran, and CINAHL for articles published in English between 1970 and 2010. We analysed cumulative data from prospective and retrospective studies, and case reports. The literature search revealed 36 relevant articles containing data on 664 patients. There was no grade A evidence found. The injury population mostly consists of young males (95.4%) with a high proportion missile injury (75.9%). Bleeding was found to be the key problem which mostly occurs from internal injury and results in shock in 10%. Overall mortality is 2.9% with significant adverse impact of visceral or vascular injury and shock (P < 0.001). The major injury pattern significantly varies between shot and stab injury with small bowel, colon, or rectum injuries leading in shot wounds, whilst vascular injury leads in stab wounds (P < 0.01). Laparotomy was required in 26.9% of patients. Wound infection, sepsis or multiorgan failure, small bowel fistula, ileus, rebleeding, focal neurologic deficit, and urinary tract infection were the most common complications. Sharp differences in injury pattern endorse an algorithm for differential therapy of penetrating buttock trauma. In conclusion, penetrating buttock trauma should be regarded as a life-threatening injury with impact beyond the pelvis until proven otherwise.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analytical review of 664 cases of penetrating buttock trauma

Lunevičius

Schulte

2011

World J Emerg Surg

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“…This recommendation dates from uncontrolled clinical studies during World War 11 (12,22) and the Vietnam conflict (13) as well as more recent civilian series (5,30). Studies of experimental gas gangrene have shown that penicillin given prophylactically prevented death in nearly 100% of mice (9), sheep (21), or guinea pigs (1,9,10).…”

mentioning

confidence: 99%

Effect of antibiotics on toxin production and viability of Clostridium perfringens

Stevens¹,

Maier²,

Mitten³

1987

Antimicrob Agents Chemother

158

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Mitten, J. Infect. Dis. 155:220-228, 1987) that clindamycin, rifampin, and tetracycline were more efficacious than penicillin in the treatment of fulminant gas gangrene in mice caused by Clostridium perfringens. We hypothesize that antibiotic efficacy correlated with bactericidal or toxin-suppressing properties of these agents. To investigate the possibility that penicillin is only bacteriostatic against C. perfingens, we performed macrobroth dilution MIC and MBC determinations using C. perfringens ATCC 13124. Mean MICs were equal to MBCs for the following antibiotics (micrograms per milliliter): clindamycin, 0.07; tetracycline, 0.05; rifampin, 0.03; metronidazole, 0.69; and penicillin, 0.27. The MIC/MBCs of chloramphenicol were 1.50/3.10 (,ug/ml). Because antibiotic efficacy did not correlate with bactericidal activity, we measured alpha-toxin activity and found complete suppression of alpha-toxin activity by tetracycline, metronidazole, rifampin, clindamycin, and chloramphenicol at concentrations equal to the MIC. In contrast, alpha-toxin activity persisted at concentrations of penicillin equal to and above the MIC. The dynamics of bacterial killing and kinetics of alpha-toxin production were next studied in log-phase cultures of C. perfringens with antibiotic concentrations 10 times the MIC. Clindamycin, metronidazole, and rifampin all caused rapid reductions in viability, turbidity, and alpha-toxin activity by 15 to 45 min. In contrast, penicillin demonstrated slower bacterial killing, increased turbidity (62.6% of control), and persistent alpha-toxin activity (80% of control values) for 2 h. Tetracycline and chloramphenicol were the least effective in reducing viability; however, the turbidity of cultures did not increase, and alpha-toxin activity was not detectable. Toxin suppression and rapid bacterial killing may in part explain the observed superior therapeutic efficacy of clindamycin, rifampin, and metronidazole compared with penicillin in the treatment of experimental gas gangrene.

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Penetrating injury to the buttock: an update

et al. 2014

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Clinical research on penetrating injury to the buttock is sparse and largely limited to case reports and clinical series. The purpose of this paper is to provide a detailed overview of literature of the topic and to propose a basic algorithm for management of penetrating gluteal injuries (PGI). MEDLINE, EMBASE, Cochran, and CINAHL databases were employed. Thirty-seven papers were selected and retrieved for overview from 1,021 records. PGI accounts for 2-3 % of all penetrating injuries, with a mortality rate up to 4 %. Most haemodynamically stable patients will benefit from traditional wound care and selective non-operative management. When gluteal fascia injury is confirmed or suspected, a contrast-enhanced CT-scan provides the most accurate injury diagnosis. CT-scan-based angiography and endovascular interventions radically supplement assessment and management of patients with penetrating injury to the major buttock and adjacent extra-buttock arteries. Immediate life-saving damage-control surgery is indicated for patients with hypovolemic shock and signs of internal bleeding. A universal basic management algorithm is proposed. This overview shows that penetrating injury to the buttock should be regarded as a potential life-threatening injury, and therefore, patients with such injuries should be managed in trauma centres equipped with hybrid operating theatres for emergency endovascular and open surgery for multidisciplinary teams operating 24/7.

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Resuscitation of battle casualties in South Vietnam: experiences at the First Australian Field Hospital

Cited by 8 publications

References 36 publications

Analytical review of 664 cases of penetrating buttock trauma

Analytical review of 664 cases of penetrating buttock trauma

Effect of antibiotics on toxin production and viability of Clostridium perfringens

Penetrating injury to the buttock: an update

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