Emergency Craniotomy and Burr-Hole Trephination in a Low-Resource Setting: Capacity Building at a Regional Hospital in Cambodia.

To evaluate the teaching effect of a trauma training program in emergency cranial neurosurgery in Cambodia on surgical outcomes for patients with traumatic brain injury (TBI). We analyzed the data of TBI patients who received emergency burr-hole trephination or craniotomy from a prospective, descriptive cohort study at the Military Region 5 Hospital between January 2015 and December 2016. TBI patients who underwent emergency cranial neurosurgery were primarily young men, with acute epidural hematoma (EDH) and acute subdural hematoma (SDH) as the most common diagnoses and with long transfer delay.

Mirror therapy for phantom limb and stump pain: a randomized controlled clinical trial in landmine amputees in Cambodia.

Background and aims The aim of the study was to examine the effect of mirror and tactile therapy on phantom and stump pain in patients with traumatic amputations, with particular reference to amputees in low-income communities. Methods The study was conducted with an open, randomized, semi-crossover case-control design in rural Cambodia. A study sample of 45 landmine victims with trans-tibial amputations was allocated to three treatment arms; mirror therapy, tactile therapy, and combined mirror-and-tactile therapy.

Early diagnosis and treatment of falciparum malaria in Cambodian trauma patients.

Asymptomatically infected patients with falciparum malaria may develop symptomatic malaria infection secondary to injury or surgery. This complication increases the risk for postoperative wound infection and adds to the burden of trauma. The aims of the present study were to investigate the preventive effect of early antimalaria treatment of Plasmodium falciparum infected trauma patients, and to study the validity and accuracy of a rapid test to identify those infected.

Prevalence of hepatitis B and hepatitis C virus infections in potential blood donors in rural Cambodia.

The aims of the present study were to provide accurate prevalence of acute and occult hepatis B infection and hepatis C infection among potential blood donors in Cambodia and to study the accuracy of ELISA tests used for blood donor screening. A cross-sectional study was performed on samples collected from potential volunteer blood donors (n = 1,200) in two districts in rural Cambodia. The samples were tested using the ELISA technique for HBsAg, anti-HBc, and anti-HCV at a local blood bank.

Non-doctors as trauma surgeons? A controlled study of trauma training for non-graduate surgeons in rural Cambodia.

Introduction: Due to the accelerating global epidemic of trauma, efficient and sustainable models of trauma care that fit low-resource settings must be developed. In most low-income countries, the burden of surgical trauma is managed by non-doctors at local district hospitals.

Objective: This study examined whether it is possible to establish primary trauma surgical services of acceptable quality at rural district hospitals by systematically training local, non-graduate, care providers.

Comparing two survey methods for estimating maternal and perinatal mortality in rural Cambodia.

Purpose: We need solid estimates of maternal mortality rates (MMR) to monitor the impact of maternal care programs. Cambodian health authorities and WHO report the MMR in Cambodia at 450 per 100,000 live births. The figure is drawn from surveys where information is obtained by interviewing respondents about the survival of all their adult sisters (sisterhood method).

Postinjury malaria: experiences of doctors in Battambang Province, Cambodia.

Quantitative studies indicate that one-third of trauma victims in malaria endemic areas of Cambodia develop postinjury malaria. The main aim of this study was to assess the medical significance of the complication. All local doctors with trauma care surgical experience in the Battambang Province of Cambodia were interviewed regarding their experiences with postinjury malaria (n = 18).

Land mine injuries: a study of 708 victims in North Iraq and Cambodia.

Objective: The aim of this study was to explore the effect of low-cost prehospital trauma systems on trauma outcome in land mine victims and to study prehospital risk indicators for better triage of land mine injuries.

Methods: A 5-year prospective study of the effect of in-field advanced life support provided by local paramedics was conducted in mine-infested areas in North Iraq and Cambodia.

Results: After implementation of a rural rescue system, there was a significant reduction in trauma mortality from 26.

Respiratory rate as a prehospital triage tool in rural trauma.

Background: Where trauma systems do not exist, such as in low-income countries, the aim of prehospital triage is identification of trauma victims with high priority for forward resuscitation. The present pilot study explored the accuracy of simple prehospital triage tools in the hands of nongraduate trauma care providers in the minefields of North Iraq and Cambodia.

Methods: Prehospital prediction of trauma death and major trauma victims (Injury Severity Score > 15) was studied in 737 adult patients with penetrating injuries and long evacuation times (mean, 6.

Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia.

Background: A five-year prospective study was conducted in North Iraq and Cambodia to test a model for rural prehospital trauma systems in low-income countries.

Results: From 1997 to 2001, 135 local paramedics and 5,200 lay First Responders were trained to provide in-field trauma care. The study population comprised 1,061 trauma victims with mean evacuation time 5.

Chronic pain in land mine accident survivors in Cambodia and Kurdistan.

The aims of the study were to study chronic pain in land mine accident survivors, and to study the impact of trauma and trauma care parameters on chronic pain. The level of chronic pain was registered (patient-rated and by clinical examination) in 57 severely injured adult land mine accident survivors in Cambodia and Northern Iraq more than one year after the accident. As all study patients had been managed by a standardized trauma system, we could assess the impact of injury severity and primary trauma care on chronic pain.

Preventing post-injury hypothermia during prolonged prehospital evacuation.

Introduction: Post-injury hypothermia is a risk predictor in trauma patients whose physiology is deranged. The aim of the present study was to examine the effect of simple, in-field, hypothermia prevention to victims of penetrating trauma during long prehospital evacuations.

Methods: A total of 170 consecutively injured landmine victims were included in a prospective, clinical study in Northern Iraq and Cambodia.