Despite advances in resuscitation and surgical management of combat wounds, infection remains a concerning and potentially preventable complication of combat-related injuries. Interventions currently used to prevent these infections have not been either clearly defined or subjected to rigorous clinical trials. Current infection prevention measures and wound management practices are derived from retrospective review of wartime experiences, from civilian trauma data, and from in vitro and animal data. This update to the guidelines published in 2008 incorporates evidence that has become available since 2007. These guidelines focus on care provided within hours to days of injury, chiefly within the combat zone, to those combat-injured patients with open wounds or burns. New in this update are a consolidation of antimicrobial agent recommendations to a backbone of high-dose cefazolin with or without metronidazole for most postinjury indications and recommendations for redosing of antimicrobial agents, for use of negative pressure wound therapy, and for oxygen supplementation in flight.
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http://dx.doi.org/10.1097/TA.0b013e318227ac37 | DOI Listing |
J Trauma Acute Care Surg
January 2025
From the Department of Orthopedic Surgery (I.F., S.B., M.T., D.P., R.B., N.G.), Chaim Sheba Medical Center at Tel Hashomer, Tel Aviv University Faculty of Medicine, Tel Aviv, Israel.
Background: Combat-related injuries have evolved in urban warfare because of close-contact engagements and high-energy blast injuries, with rapid medical evacuation improving survival rates. This study analyzes injury patterns and outcomes in the Gaza conflict, emphasizing the need to optimize trauma care protocols in modern combat environments, particularly because of the unique proximity of conflict zones to tertiary trauma centers.
Methods: A retrospective study was conducted at a single center involving 189 patients evacuated by helicopter to a Level I tertiary trauma center.
BMC Emerg Med
December 2024
The Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.
Background: In the complex landscape of modern warfare, understanding combat-related injuries leading to hospitalization is crucial for optimizing injury treatment. This study aims to compare combat casualty characteristics and outcomes during the major conflicts between Israel and Hamas in 2023 and 2014 as a basis for understanding the effectiveness of trauma care practices for wounded soldiers.
Methods: A cohort study of soldiers hospitalized due to combat injuries during two major wars between Israel and Hamas in 2023 and 2014, using data from the Israeli National Trauma Registry.
Injury
November 2024
Department of Thoracic and Vascular Surgery, Sainte Anne Military Teaching Hospital, Toulon, France.
Objective: Vascular surgery for war-related traumatic injuries represents 3 to 17.6 % of all emergency surgical procedures, and around 5 % in French Medical Treatment Facilities (MTFs). Most of these lesions are treated by open surgery, but the role of endovascular surgery in French MTFs has not been assessed yet.
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November 2024
Israel Defense Forces, Medical Corps, Kiryat Ono, Israel; The Institute of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
Orthop Traumatol Surg Res
November 2024
Hôpital d'instruction des Armées Percy, Clamart, France.
While the first conflicts of the 21st century involved asymmetric warfare in the fight against terrorism, recent geopolitical events require us to prepare for the possibility of high-intensity conflicts. Modern wounding agents mainly consist of explosive devices and high-velocity bullets. Every trauma surgeon must be familiar with the mechanisms of injury specific to armed conflicts.
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