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Wartime Soft Tissue Coverage Techniques for the Deployed Surgeon.

Vilas Saldanha1,2, Nathan Tiedeken3, Brandon Godfrey2

  • 1Department of Surgery, University of Nevada School of Medicine, 1701 W Charleston Blvd, Suite 490, Las Vegas, NV.

Military Medicine
|March 29, 2018
PubMed
Summary
This summary is machine-generated.

Military surgeons face challenging extremity wounds from combat. This study reviews 12 cases, highlighting successful soft tissue reconstruction techniques like skin grafts and flaps for improvised explosive device (IED) and gunshot wounds.

Keywords:
War woundsflapskin graftsoft tissue coverage

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Area of Science:

  • Orthopedic Surgery
  • Combat Medicine
  • Wound Management

Background:

  • Military orthopedic surgeons encounter complex high-energy extremity injuries in conflict zones.
  • Management of associated soft tissue injuries presents significant technical challenges.
  • Standardized care plans for these unique wartime wounds are still evolving.

Purpose of the Study:

  • To highlight typical wartime extremity injury cases.
  • To present effective solutions for associated soft tissue injuries.
  • To inform deployed surgeons on reconstructive techniques.

Main Methods:

  • Retrospective case series analysis.
  • Inclusion of 12 patients treated by a single orthopedic surgeon in a Role 3 combat support hospital.
  • Documentation of various soft tissue coverage techniques employed.

Main Results:

  • Eleven of 12 patients achieved successful outcomes.
  • Common injuries included improvised explosive device (IED) and high-velocity gunshot wounds (HVGSW).
  • Successful treatments involved split-thickness skin grafts (STSG), flaps, and Integra, even with exposed bone.

Conclusions:

  • Deployed surgeons must master diverse soft tissue coverage techniques for definitive wound management.
  • Meticulous debridement is fundamental for successful reconstructive options.
  • Flaps, synthetic materials, and skin grafting offer viable solutions for complex combat wounds.