PMID: 8606403Mar 1, 1996Paper

Management of small fragment wounds: experience from the Afghan border

The Journal of Trauma
G W Bowyer

Abstract

Fragmenting munitions have caused the majority of casualties in recent conflicts. These wounds are often multiple, many affecting only the soft tissues of the extremities. The management of these wounds is controversial; some surgeons advocate aggressive surgical treatment; others believe that a nonoperative policy is appropriate in selected cases. The International Committee of the Red Cross has a great deal of experience in treating the wounds of war. It maintains a war surgery hospital in Pakistan, close to the Afghan border, receiving wounded from the ongoing conflict in Afghanistan. This paper describes the number, distribution, and severity of more than 1200 fragment wounds. These injuries were sustained by 83 casualties who presented to the hospital during a recent flare-up in the fighting. The majority of these fragment wounds affected the limbs. Small-fragment wounds affecting only the skin and muscle were managed nonoperatively, with antibiotics and dressings. More than 850 wounds were managed in this way. There were complications in only two of the 63 casualties who had wounds that were treated nonoperatively. The complications were localized abscesses, one of which required surgical drainage. The policy of carefully...Continue Reading

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Citations

Jun 27, 2007·Prehospital and Disaster Medicine·Hazem M HamoudaOystein P Nygaard
Mar 20, 2008·The Journal of Trauma·Duane R HospenthalJohn B Holcomb
Oct 14, 2008·The Journal of Trauma·Arul RamasamyMichael P M Stewart
Apr 20, 2010·Journal of the Royal Army Medical Corps·A RamasamyJ C Clasper
Jun 4, 2015·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·A ÜnlüP Petrone
Aug 1, 2014·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·L Riddez
Jul 28, 2020·Frontiers in Bioengineering and Biotechnology·Thuy-Tien N NguyenSpyros D Masouros
Apr 20, 2001·Journal of the Royal Army Medical Corps·P Barker
Oct 17, 2009·Annals of the Royal College of Surgeons of England·A RamasamyM Midwinter
Nov 24, 2004·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Dragan Nikolić
Dec 15, 2010·Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences·W G P EardleyJ C Clasper
May 31, 2013·Journal of the Royal Army Medical Corps·William G P EardleyJ C Clasper
Nov 20, 2014·The Open Orthopaedics Journal·Daniel J JordanSandip Hindocha
Feb 19, 2005·Journal of Pediatric Orthopedics·Daniel M WeiglKalman Katz
Mar 20, 2008·The Journal of Trauma·Clinton K MurrayJason H Calhoun
Jan 28, 2014·International Journal of Environmental Research and Public Health·José A CentenoBenjamin K Potter
Sep 10, 2020·Frontiers in Bioengineering and Biotechnology·Iain A RankinSpyros D Masouros
Sep 20, 2011·The Journal of Trauma·Clinton K MurrayUNKNOWN Prevention of Combat-Related Infections Guidelines Panel
Jun 25, 2015·Current Reviews in Musculoskeletal Medicine·Wade GordonDavid Dromsky
Sep 28, 2006·The Journal of the American Academy of Orthopaedic Surgeons·Dana C Covey
Oct 13, 2020·Frontiers in Bioengineering and Biotechnology·Thuy-Tien N NguyenSpyros D Masouros
May 4, 2021·Frontiers in Bioengineering and Biotechnology·Iain A RankinSpyros D Masouros
Mar 8, 2000·Injury·D NikolicM Mladenovic

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