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Multiple blast extremity injuries: is definitive treatment achievable in a field hospital for local casualties?
Laurent Mathieu1, Erwan Saint-Macary, Martin Frank
1Clinic of Traumatology and Orthopaedics, Desgenettes Military Hospital, Lyon, France, laurent.mathieu69@yahoo.fr.
Purpose:
The objective of this report was to analyse injury patterns and definitive management of local casualties with multiple blast extremity injuries in the Kabul International Airport Combat Support Hospital.
Methods:
A clinical prospective study was performed from July 2012 to January 2013. Afghan victims of a blast trauma with a minimum of two extremities injured and an Injury Severity Score (ISS) greater than 8 were included. Two groups were considered for analysis: group A including patients with amputations and group LS including patients with limb salvage procedures.
Results:
During this period 19 patients were included with a total of 57 extremity injuries. There were six patients in group A and 13 patients in group LS, with a mean number of injuries of 3.5 and 2.8, respectively. The ISS, blood products utilization and overall time of surgery were significantly greater in group A.
Conclusion:
Reconstruction of multiple blast extremity injuries may be achieved in a field hospital despite limited resources and operational constraints. However, this activity requires the utilization of significant supplies and major investment from the caregivers deployed.
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