Advances in medicine, protective equipment, and surgical reconstruction have led to questions about when to emphasize limb salvage over amputation for individuals with severe blast injuries. The authors summarize recent research on the topic.
This resource addresses all aspects of combat amputee care ranging from surgical techniques to long-term care, polytrauma and comorbidities such as traumatic brain injury and burns, pain management, psychological issues, physical and occupational therapy, VA benefits, prosthetics and adaptive technologies, sports and recreational opportunities, and return to duty and vocational rehabilitation.
Standards for the Management of Open Fractures provides an evidence-based approach for the management of open fractures, focussing on lower limb injuries. It builds on and expands the NICE Guidelines to provide a practical approach with supporting evidence. The new edition has been extensively updated and expanded to include key aspects of management, ranging from setting up an orthoplastic service, through to dealing with the bone and soft tissue injures, complications such as infection, and patient rehabilitation and psychological care. The book is primarily aimed at trainee plastic, orthopaedic and trauma surgeons (particularly for expanding knowledge and examination revision) but would also appeal to established surgeons to improve patient care. Standards for the Management of Open Fractures is an open access title. It is available to read and download as a free PDF version on Oxford Medicine Online. It has been made available under a Creative Commons Attribution-Non Commercial No Derivatives 4.0 International licence.
This practical and generously illustrated text presents the current concepts regarding the management of the mangled extremity, including microsurgery, vascular surgery, free tissue, nerve, hand, and replantation surgery. Since the advent of microsurgical reconstruction, significant progress has been made in the areas of replantation, free tissue transfer, as well as the refinement of skeletal fixation techniques. The scope will encompass the initial triage of a patient with a mangled upper or lower extremity, the initial and subsequent reconstructive efforts, to include skeletal fixation, vascular and soft tissue reconstruction, muscle and tendon transfers, psychological impact, therapy requirements, amputation considerations, and current data on salvage versus amputation in these scenarios. Case examples will be included to add further depth and context to the techniques and recommendations provided. Presenting these surgical challenges in detail, The Mangled Extremity will be an ideal resource for orthopedic and trauma surgeons, residents and fellows, as well as emergency surgeons facing these intense, traumatic injuries.
A first class summary of the management principles of clinical cases in vascular surgery. With an international panel of contributors, many of whom are also examiners on the UK, European or American Boards of Vascular Surgery, this book familiarizes the reader quickly with day-to-day clinical practice. Case presentations are given in question and answer format and have been widely referenced to reassure the reader that the contents are established best practice. Each case is accompanied by 3 to 4 x-rays or color illustrations for visual clarity.
Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.
This book provides a practical guide to decision making within the realm of trauma surgery. Each chapter covers the ideal approach, rather than customary care, for the treatment of the chosen difficult decision or controversy. A broad range of topics are covered with particular attention given to resuscitation, wound management, thoracic and abdominal trauma, antimicrobial management, transplant considerations, vascular trauma, traumatic brain injury, pediatric trauma and ethics. Difficult Decisions in Trauma Surgery aims to help improve the treatment of trauma patients and is relevant to surgical trainees and practicing surgeons, and as well as medical professionals working within trauma medicine.
This text is designed to present a comprehensive and state-of the-art approach to dismounted complex blast injuries. Sections address care of these patients from the point of injury through rehabilitation. The specific areas addressed include blast mechanics, stabilization and hemorrhage control at the point of injury, early resuscitation at local hospitals, a systematic approach to surgical care, and finally reconstruction and rehabilitation. Specific chapters focus on operative management of pelvic, abdominal, genitourinary, orthopedic, neurological and thoracic injuries. The authors of each chapter, are experts in treating DCBIs that have had direct hands-on experience through military deployments in Iraq and Afghanistan. Each chapter describes patient presentation and an algorithm outlining treatment with support from the literature. The text will conclude with three chapters. The first explores new advances in care that can be applied to these injuries. The second highlights the organization and team approach to care of these patients. Finally, the last chapter describes an actual case, cared for by the editors, that encompasses points from the chapters in the text. Extensive illustrations and flow diagrams are used throughout the text. This text is specifically designed to be a “how to” guide for inexperienced military and civilian providers. The chapters are organized in a step-wise fashion that mirrors the patient’s course from point of injury through their hospital course. Combining authors’ experience with illustrations and algorithm diagrams creates a text that is easy to use as a reference text or basis of training for future military and civilian surgeons.