War Injuries of Major Extremity Vessels

Reflexões sobre o trauma cardiovascular civil a partir de um estudo prospectivo de 1000 casos atendidos em um centro de trauma de nível I: a prospective study from 1000 cases

“…No entanto, o trauma tornou-se um dos maiores desafios para o sistema assistencial de saú-de de todos os países do mundo, sendo o trauma vascular componente importante deste problema [3][4][5][6][7][8][9][10][11][12][13][14] . Apesar disso, a maioria das grandes séries sobre trauma cardiovascular é baseada em conflitos militares 1,2,9,[15][16][17] , pois estudos epidemiológicos sobre trauma cardiovascular civil são difí-ceis de serem realizados e analisados [18][19][20] . Por outro lado, a epidemiologia clínica tem se revelado como poderosa ferramenta capaz de preencher lacunas científicas e proporcionar uma melhor compreensão dos fenômenos sociais e agravos à saúde existentes [21][22][23][24][25][26][27][28][29] .…”

War Injuries of the Extremities: Twelve-Year Follow-Up Data

“…Although the MESS system is a relatively simple, readily available, scoring system of objective criteria that is highly accurate in acutely discriminating between limbs that are salvageable The application of external fixation may be the first and definitive choice of treatment for war-related open fractures of the extremities and, by leaving the opportunity for early physical therapy, may improve the range of motion of the joints. 1,2,4,5,10,11,15 Many experiences from the homeland war in Croatia in 1991-1995 confirm this attitude. 1,4,6,15 Based on our small series of wounded and 12-year follow-up data, with a high rate of infection (33%) when internal fixation with plates (two of six cases) or wires (two patellas) was applied as primary management and problems only with pin-tract osteomyelitis with external fixation, we strongly recommend external fixation as the primary and definitive method for treating war-related open fractures.…”

“…[1][2][3][4] Two-thirds of injuries are caused by shell fragments, which cause open fractures in one-third of wound cases, usually with highly contaminated wounds and major soft tissue destruction. 1,2,[5][6][7] The use of external fixation in the management of such injuries is the method of choice, although, concerning the extent of soft tissue and bone damage, some authors dealing with open fractures suggest another approach. [7][8][9][10][11] Such injuries are followed by a high risk of osteomyelitis attributable to many free and deperiosted bone fragments, as well as covering tissue defects and concomitant vascular injuries.…”

Femoral Vessel Injuries in Modern Warfare since Vietnam

“…The highest reported mortality for femoral vessel injury of 100/0 was in Croatia. 3 The mortality rate offemoral vessel injuryin the most recent conflicts involving the United States doesnot approach the 10 % mark. However, a significant percentage of the deaths are a direct result of femoral vessel injury.…”

“…[1][2][3] Mostwounds require simple debridement and wound care. Despite the overall lowmortalityoflower extremityinjuries, a high percentage of amputations and many deaths in modem conflict~are attri?utable to vascular injury in the lowerextremity, particularlyWith the femoral vessels.1-6 The most distressing are reports ofpreventabledeaths ofservice personnel due to femoral vessel injuries.…”