Extremity war injuries: Development of clinical treatment principles

James R. Ficke, Andrew N. Pollak

Research output: Contribution to journalArticle

Abstract

The AAOS/OTA Extremity War Injuries: Development of Clinical Treatment Principles symposium, held in January 2007, was a follow-up to the first Extremity War Injuries symposium held a year earlier. Discussion focused on four specific areas: prehospital management of extremity wounds, initial debridement, early stabilization, and postoperative wound management during air evacuation. Liberal emergency use of field tourniquets likely is contributing to lower overall mortality and is associated with very low rates of complications. Additional tools for extremity hemorrhage control, such as chitosan-based patches and granular zeolite hemostat, were postulated to be effective. Consensus opinion was that necrotic, devitalized, and contaminated tissue must be removed although objective assessment of completeness of initial debridement is difficult. Definitive open reduction and internal fixation for US and Coalition forces in the theater of operations should be limited to fracture patterns associated with significant perceived risk of delay in treatment. Finally, primary skin closure should be avoided in theater. In addition, because of the time and complications involved in transporting patients to level 4 care facilities, surgeons should consider release of compartments prior to patient transport whenever significant perceived potential for compartment syndrome is present.

Original languageEnglish (US)
Pages (from-to)590-595
Number of pages6
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume15
Issue number10
DOIs
StatePublished - Oct 2007
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Extremity war injuries: Development of clinical treatment principles'. Together they form a unique fingerprint.

  • Cite this