Wound Management in Disaster Settings

Abstract

BackgroundFew guidelines exist for the initial management of wounds in disaster settings. As wounds sustained are often contaminated, there is a high risk of further complications from infection, both local and systemic. Healthcare workers with little to no surgical training often provide early wound care, and where resources and facilities are also often limited, and clear appropriate guidance is needed for early wound management.MethodsWe undertook a systematic review focusing on the nature of wounds in disaster situations, and the outcomes of wound management in recent disasters. We then presented the findings to an international consensus panel with a view to formulating a guideline for the initial management of wounds by first responders and subsequent healthcare personnel as they deploy.ResultsWe included 62 studies in the review that described wound care challenges in a diverse range of disasters, and reported high rates of wound infection with multiple causative organisms. The panel defined a guideline in which the emphasis is on not closing wounds primarily but rather directing efforts toward cleaning, debridement, and dressing wounds in preparation for delayed primary closure, or further exploration and management by skilled surgeons.ConclusionGood wound care in disaster settings, as outlined in this article, can be achieved with relatively simple measures, and have important mortality and morbidity benefits.

One hundred up: the Weary Dunlop Boonpong Scholarship

“…All three surgeons have published their work in national, regional and, in the case of Dr Witaya Chadbunchachai, international journals . Another WDBP scholar was the lead author on a systematic review of management of injuries in disaster scenarios, a particularly relevant topic in low‐ and middle‐income countries …”

“…[11][12][13][14][15] Another WDBP scholar was the lead author on a systematic review of management of injuries in disaster scenarios, a particularly relevant topic in low-and middle-income countries. 16 Capacity building also requires new services to be embedded in a healthcare system by developing sustainable local training programmes. This is highlighted in a regional vascular training programme and the development of national strategies for provision of radiotherapy and trauma services.…”

Мікрофлора Інфікованих Ран, Отриманих Під Час Землетрусів

“…При її проведенні слід забезпечувати форсований діурез із досягненням виділення сечі по 100-200 мл/год, підлужнювати сечу (рН 6,5 і більше), підтримувати артеріальну рН < 7,5. Гемодіаліз призначати при рівні креатиніну більше ніж 1,5 мг/дл [3]. Встановлено, що при розвитку гострої ниркової недостатності зростає ризик розвитку інфекційних ускладнень.…”

“…Сумарні дані щодо збудників з інфікованих ран, пов'язаних зі надзвичайними ситуаціями, подані в табл. 1 (Wuthisuthimethawee P. et al, 2015) [3].…”

“…Профілактика антибіотиками широкого спектра сприяє зниженню інфікування й швидшому загоєнню ран. У випадках, коли першочергові антибактеріальні препарати неефективні, до них підключають хіноліни [3].…”