War-related extremity injuries in children: 89 cases managed in a combat support hospital in Afghanistan

Bertani, Antoine; Laurent, Michel; Dahan, J.; Launay, Franck; Rongièras, Frédéric; Rigal, Sylvain

doi:10.1016/j.otsr.2015.02.003

Cited by 15 publications

(13 citation statements)

References 13 publications

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“…Although saphenous vein was preferred mostly, also cephalic vein could be used successfully as an autogenous graft. 22 In our study, our results were similar to the literature.…”

Section: Discussionsupporting

confidence: 92%

Analysis of Vascular Trauma in Terror-Related Civilian Attacks Within South-Eastern Turkey

Fansa¹,

Atay²,

Altınay³

et al. 2016

Damar Cer Derg

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To evaluate the results of terror related vascular injuries and predictors of mortality caused by these injuries in SouthEastern Turkey. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Eighty-eight patients (82 men, 24.4 ± 8.1 years) who had vasculary trauma in terrorist attacks between January 2012-August 2015 in SouthEastern Turkey included in this retrospective study. Patients with traumatic amputations, extensive tissue losses, amputations after severe nerve damage and head injuries were excluded. Study patients were analyzed according to the mechanism and severity of injury, location of trauma, and surgical treatment options. R Re es su ul lt ts s: : Forty-six (52.3%) patients had lower limb, 19 (21.6%) patients had upper limb, 13 (14.8%) patients had both upper and lower limb vascular injuries. Other vascular injuries involved neck (n=3; 3.4%), thorax (n=2; 2.3%), abdomino-pelvic (n=5; 5.7%) locations. Twenty-three (26.1%) of them were caused by bullets, 54 (61.4%) by shrapnel and 11 (12.5%) by bombs and explosions. Thirty-eight (43.2%) of these patients were in hypovolemic shock at admittance. Forty patients (45.5%) had isolated arterial, 42 (47.7%) patients had both artery and vein, 6 (6.8%) patients had isolated vein injuries. Autogenous grafts were used in 28 (31.8%) patients, and synthetic grafts were used in 10 (11.4%) patients. Vascular ligations were performed in 18 (20.5%) patients. Seven (8%) patients had acute renal injury and 28 (31.8%) patients had wound infections postoperatively. Overall in-hospital mortality rate was 18.2% (16 patients). Hypovolemic shock (p<0.0001), acute renal failure (p=0.002) and massive blood transfusion (p=0.007) were the main predictors of mortality. C Co on nc cl lu us si io on n: : Vascular injuries in terror-related trauma victims require multidisiplinary urgent treatment of hypovolemic shock, preventive measures to avoid acute renal failure and immediate complex vascular surgery. K Ke ey yw wo or rd ds s: : Gunshot wounds; vascular system injuries; vascular grafting; limb salvage. Ö ÖZ ZE ET T A Am ma aç ç: : Türkiye'nin Güneydoğusu'nda meydana gelen teröre bağlı vasküler yaralanmalar ve mortalite göstergelerini incelemek. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Ocak 2012-Ağustos 2015 arasında teröre bağlı vasküler yaralanması olan 88 hasta (82 erkek, yaş 24.4±8.1) bu retrospektif çalışmaya alındı. Travmatik amputasyon, yaygın doku kaybı, ciddi sinir hasarına bağlı amputasyon ve baş yaralanması olan hastalar çalışmaya alınmadı. Hastalar yaralanmanın ciddiyeti ve mekanizması, travma lokalizasyonu ve cerrahi tedavi şekillerine göre değerlendirildi. B Bu ul lg gu ul la ar r: : Kırkaltı (%52.3) hastada alt ekstremite, 19 (%21.6) hastada üst ekstremite, 13 (%14.8) hastada alt ve üst ekstremitede vasküler yaralanma vardı. Ayrıca boyun (n=3; %3.4), toraks (n=2; %2.3), abdomino-pelvik (n=5; %5.7) yaralanmalar da vardı. Yaralanmaların 23'ü (%26.1) mermi, 54'ü (%61.4) şarapnel, 11'i (%12.5) patlama sebebiyle meydana gelmişti. Hataların 38'i (%43.2)...

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“…Although saphenous vein was preferred mostly, also cephalic vein could be used successfully as an autogenous graft. 22 In our study, our results were similar to the literature.…”

Section: Discussionsupporting

confidence: 92%

Analysis of Vascular Trauma in Terror-Related Civilian Attacks Within South-Eastern Turkey

Fansa¹,

Atay²,

Altınay³

et al. 2016

Damar Cer Derg

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“…Considering the impact of warfare, children are more at risk compared to the other members of society (Analyti, ; Sailea, Ertla, Neunera, & Catania, ; Zganec, ). Warfare and migration can lead to injury, disability, or death of children (Avogo & Agadjanian, ; Bertani et al, ; Denov & Marchand, ). Many children lose their parent, their relatives, friends and their childhood.…”

Section: Introductionmentioning

confidence: 99%

Emotional indicators and anxiety levels of immigrant children who have been exposed to warfare

Celik

Altay

Yurttutan

et al. 2019

Child Adoles Psych Nursing

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Problem Little is known about the emotional reactions of children who have migrated to another country fleeing a war in their home. Purpose This descriptive study was conducted to compare the emotional indicators and anxiety levels of Syrian children who have migrated to Turkey following the war with anxiety levels of Turkish children. Methods The study has been completed with 125 children who migrated from Syria and 168 children who are living in Turkey. The demographic data form, the Spielberger state and trait anxiety inventory (STAI) and Koppitz Draw‐A‐Person test were used for data collection. Findings The average ages of Syrian and Turkish children who participated in the study are 9.14 ± 1.11; 8.89 ± 0.76, respectively. Emotional indicators such as impulsivity, anxiety, and anger appear more frequently in Syrian children's drawings compared to the drawings of Turkish children. State anxiety scores were 47.44 ± 8.09 in Syrian children and 32.16 ± 10.46 in Turkish children. Trait anxiety scores were 49.08 ± 7.98 in Syrian children and 39.76 ± 8.58 in Turkish children. The STAI score of Syrian children was higher compared to the score of Turkish children. Conclusions Anxiety scores of children who have migrated are significantly higher than those of children residing in their country of origin. The physical and psychological evaluation of children who have witnessed warfare and have migrated is an important nursing initiative.

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“…The prevalence of head injuries following blasts are diverse, ranging from 6% to 54%,10–12 14 36 43 45 46 59 61 62 65–70 while adult combat data range from 16% to 29% 53. This variation is due to the heterogeneous definitions of head injury described in these studies, with few studies differentiating between superficial scalp wounds, blunt traumatic brain injury (TBI) or penetrating TBI.…”

Section: Resultsmentioning

confidence: 99%

“…Despite only comprising 0.3% of the anterior body surface, the eye is sensitive to blast injury, with ocular injuries in 4%–28% of children following trauma related to combat or ERW 34 36 43 45 59 62 65 66 71. In keeping with patterns of facial injury, an increased prevalence of eye injury is associated with blast injuries compared with GSW (13% vs 3%) 10.…”

Section: Resultsmentioning

confidence: 99%

“…Following blast injury, trauma to the torso is common, varying from 12% to 46% between studies10 12 19 24 43 45 46 59 61 64–70 and peaking in 5–10 year olds 11 16. Er et al ’s67 study on civilian paediatric injuries during the Syrian Civil War noted that the abdomen was less commonly injured compared with adults (12% vs 20%), while chest injury with accompanying lung contusion was present in 51% of children with torso injuries, compared with 35% in adults.…”

Section: Resultsmentioning

confidence: 99%

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Blast injuries in children: a mixed-methods narrative review

Hargrave

Pearce

Mayhew

et al. 2019

bmjpo

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Background and significanceBlast injuries arising from high explosive weaponry is common in conflict areas. While blast injury characteristics are well recognised in the adults, there is a lack of consensus as to whether these characteristics translate to the paediatric population. Understanding blast injury patterns in this cohort is essential for providing appropriate provision of services and care for this vulnerable cohort.MethodsIn this mixed-methods review, original papers were screened for data pertaining to paediatric injuries following blasts. Information on demographics, morbidity and mortality, and service requirements were evaluated. The papers were written and published in English from a range of international specialists in the field.ResultsChildren affected by blast injuries are predominantly male and their injuries arise from explosive remnants of war, particularly unexploded ordinance. Blasts show increased morbidity and mortality in younger children, while older children have injury patterns similar to adults. Head and burn injuries represent a significant cause of mortality in young children, while lower limb morbidity is reduced compared with adults. Children have a disproportionate requirement for both operative and non-operative service resources, and provisions for this burden are essential.ConclusionsCertain characteristics of paediatric injuries arising from blasts are distinct from that of the adult cohort, while the intensive demands on services highlight the importance of understanding the diverse injury patterns in order to optimise future service provisions in caring for this child blast survivor.

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War-related extremity injuries in children: 89 cases managed in a combat support hospital in Afghanistan

Cited by 15 publications

References 13 publications

Analysis of Vascular Trauma in Terror-Related Civilian Attacks Within South-Eastern Turkey

Analysis of Vascular Trauma in Terror-Related Civilian Attacks Within South-Eastern Turkey

Emotional indicators and anxiety levels of immigrant children who have been exposed to warfare

Blast injuries in children: a mixed-methods narrative review

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