Prolonged tactical tourniquet application for extremity combat injuries during war against terrorism in the Sahelian strip.
Purpose: This study reports on complications following extended tourniquet application in patients with combat extremity injuries treated by the French Military Health Service in the Sahelian strip. Methods: A retrospective review was performed in a French forward medical treatment facility deployed...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 48; no. 5; pp. 3847 - 3855 |
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| Autores principales: | , , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Oct2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=159499523&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 159499523 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Oct2022 vid: 48 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 159499523 153549833 159499523 159499523 10.1007/s00068-021-01828-4 159499523 ppf: 3847 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Prolonged tactical tourniquet application for extremity combat injuries during war against terrorism in the Sahelian strip. aug: au: Sabate-Ferris, Alexandre Pfister, Georges Boddaert, Guillaume Daban, Jean-Louis de Rudnicki, Stéphane Caubere, Alexandre Demoures, Thomas Travers, Stéphane Rongieras, Fréderic Mathieu, Laurent affil: Department of Orthopedic, Trauma and Reconstructive Surgery, Percy Military Hospital, Clamart, France sug: subj: Terrorism War Wounds and Injuries Therapy Extremities Injuries Tourniquets Adverse Effects Tourniquets Utilization Compartment Syndromes Hemorrhage Multiple Trauma Rhabdomyolysis Etiology Wounds, Gunshot Complications Wounds, Gunshot Surgery Retrospective Design Blast Injuries Mass Casualty Incidents Military Health Services Shock, Hemorrhagic Fracture Fixation Emergency Medical Services Amputation Rhabdomyolysis Morbidity Debridement External Fixators Fasciotomy Human Male Female Young Adult Adult Descriptive Statistics Adult: 19-44 years Male Female ab: Purpose: This study reports on complications following extended tourniquet application in patients with combat extremity injuries treated by the French Military Health Service in the Sahelian strip. Methods: A retrospective review was performed in a French forward medical treatment facility deployed in Gao, Mali, between 2015 and 2020. All patients treated for an extremity injury with the application of at least one tourniquet for a minimum of 3 h were included. Prehospital data were injury pattern, associated shock, tourniquet location, and duration. Subsequent complications and surgical procedures performed were analyzed. Results: Eleven patients with a mean age of 27.4 years (range 21–35 years) were included. They represented 39% of all patients in whom a tourniquet was applied. They had gunshot wounds (n = 7) or multiple blast injuries (n = 4) and totaled 14 extremity injuries requiring tourniquet application. The median ISS was 13 (interquartile range: 13). Tourniquets were mostly applied proximally on the limb for a mean duration of 268 min (range 180–360 min). Rhabdomyolysis was present in all cases. The damage control surgeries included debridement, external fixation, vascular repair, and primary amputation. Ten injuries were complicated by compartment syndrome requiring leg or thigh fasciotomy in the field or after repatriation. Two severely injured patients died of their wounds, but the others had a favorable outcome even though secondary amputation was sometimes required. Conclusions: Extended and proximal tourniquet applications led to significant morbidity related to compartment syndrome and rhabdomyolysis. Hemorrhagic shock, mass casualty incident, and tactical constraints often precluded revising the temporary tourniquet applied under fire. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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