Topical Antibiotics in War Wounds: A Re-Evaluation

Heisterkamp, Charles A.; Vernick, Jerome; Simmons, Richard L.; Motsumoto, Teruo

doi:10.1093/milmed/134.1.13

Cited by 22 publications

(9 citation statements)

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“…Mortality from all wounds decreased dramatically across the 20th century, from 8.5% among US troops in World War I [36], to 3.3% in World War II [118], to 2.4% in Korea [120], and leveling at 2.6% in Vietnam [58]. Improvements in surgical management stopped the scourge of Clostridium-associated gas gangrene, which had a 5% incidence and 28% mortality among US troops in World War I but had fundamentally disappeared by the Korean War [65]. Likewise, the mortality of patients with abdominal wounds declined from 21% in World War II to 12% in Korea and 4.5% in Vietnam [60].…”

Section: Discussionmentioning

confidence: 99%

Treatment of War Wounds: A Historical Review

Manring

Hawk

Calhoun

et al. 2009

Clinical Orthopaedics &Amp; Related Research

142

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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.

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Section: Discussionmentioning

confidence: 99%

Treatment of War Wounds: A Historical Review

Manring

Hawk

Calhoun

et al. 2009

Clinical Orthopaedics &Amp; Related Research

142

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show abstract

“…This route is suitable for all kinds of patients and wounds, and absorption of the drug is usually acceptable. Topically administeredantibiotics(oxytetracycline and a combination spray that consists of neomycin, bacitracin, and polymyxin) were used successfully in Vietnam [28]. But when topical antibiotics are administered in combination with effective systemic antibiotics immediately after injuries are sustained, the addition of topical antibioticsdoes not lower infection rates any further.…”

Section: Combinations Of Antibioticsmentioning

confidence: 99%

Characteristics of the Ideal Antibiotic for Prevention of Wound Sepsis Among Military Forces in the Field

Hell

1991

Clinical Infectious Diseases

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“…4,5 This treatment practice is based on several studies conducted in the 1960s and 1970s, which showed improvements in healing rates and decreased infections with topical antibiotics use. 6 The infection rates in these early studies ranged from 12% to 40% before treatment, 7,8 so improvements with antibiotic use were not surprising; however, the wounds described in these studies included porcine wound models, 9 war wounds, 8 and playground abrasions in schoolchildren, 10 and therefore do not represent the typical wounds dermatologists create in their offices during routine procedures conducted under clean conditions. 6 More recent studies have shown that the infection rate for postoperative wounds is very low, typically less than 1.5%.…”

Section: Ahomentioning

confidence: 99%