thedrifter
01-30-07, 08:31 AM
Doctors: Update manuals for today’s wounds, methods
By Kelly Kennedy - Staff writer
Posted : February 05, 2007
With the number of service members wounded in Iraq reaching 23,114 as of Jan. 25, members of the American Academy of Orthopaedic Surgeons have had plenty of opportunities to look at the way injuries are handled in the combat zone.
What they’ve found is that the unconventional warfare in Iraq shows that some conventional treatments for extremity war injuries may be outdated — and that the Defense Department may need to look at changing training and surgery manuals.
For example, surgeons argued that tourniquets should not be taught as a last resort that automatically leads to amputation, and that irrigating wounds to remove harmful bacteria could actually push the bad bugs further into the flesh.
At the annual Extremity War Injuries symposium in Washington, D.C., on Jan. 24-27, physicians and researchers met to talk about what works and how they can do things better. To that end, speakers also talked about applying for grant money and stressing the immediacy of their research.
“If it doesn’t have relevance or it doesn’t have an impact, who cares?” said Joseph Wenke, manager for the Army’s Orthopaedic Trauma Research Program at the Institute of Surgical Research. “We’re looking for proposals that will make a difference within five years.”
Surgeons have known since the Trojan Wars that combat wounds tend to be much more complex that those suffered in the civilian world. Conditions are dirtier, people often have to be treated as fighting continues around them, and it can take some time before they make it to a hospital.
In today’s wars, the wounded often have multiple injuries, as well as contamination caused when explosive high-velocity munitions push bacteria deep into the body. In Iraq, 70 percent of injuries are to service members’ extremities.
In 2006, Congress gave the academy $7.5 million through appropriations to create the Orthopaedic Trauma Research Program, which is using the money for grants relating to combat trauma — everything from using existing muscles to control prosthetic devices, to figuring out just how much flesh needs to be removed around a wound to prevent infection.
Some of the results have been surprising. Army Col. John Kragh Jr., an orthopedist at the Army Institute of Research at Fort Sam Houston, Texas, reported that using a tourniquet in combat results in amputation only 1 percent of the time. But people are often taught that they should use a tourniquet only as a last resort because it will result in an amputation.
Kragh argued that with proper monitoring and placement, that’s just not true.
And Navy Capt. Frank Butler, medical consultant to the Navy’s Medical Lessons Learned Center, said not using tourniquets has resulted in some deaths that were “potentially preventable.”
Army Col. Roman Hayda, acting chief of orthopedic services at Brooke Army Medical Center, gave a presentation about contamination and war wounds. He reported that recent studies show some irrigation methods — common practice for extremity wounds — may actually push infection further into a wound, and that more research needs to be done to find the best means to clean out a wound.
Ellie
By Kelly Kennedy - Staff writer
Posted : February 05, 2007
With the number of service members wounded in Iraq reaching 23,114 as of Jan. 25, members of the American Academy of Orthopaedic Surgeons have had plenty of opportunities to look at the way injuries are handled in the combat zone.
What they’ve found is that the unconventional warfare in Iraq shows that some conventional treatments for extremity war injuries may be outdated — and that the Defense Department may need to look at changing training and surgery manuals.
For example, surgeons argued that tourniquets should not be taught as a last resort that automatically leads to amputation, and that irrigating wounds to remove harmful bacteria could actually push the bad bugs further into the flesh.
At the annual Extremity War Injuries symposium in Washington, D.C., on Jan. 24-27, physicians and researchers met to talk about what works and how they can do things better. To that end, speakers also talked about applying for grant money and stressing the immediacy of their research.
“If it doesn’t have relevance or it doesn’t have an impact, who cares?” said Joseph Wenke, manager for the Army’s Orthopaedic Trauma Research Program at the Institute of Surgical Research. “We’re looking for proposals that will make a difference within five years.”
Surgeons have known since the Trojan Wars that combat wounds tend to be much more complex that those suffered in the civilian world. Conditions are dirtier, people often have to be treated as fighting continues around them, and it can take some time before they make it to a hospital.
In today’s wars, the wounded often have multiple injuries, as well as contamination caused when explosive high-velocity munitions push bacteria deep into the body. In Iraq, 70 percent of injuries are to service members’ extremities.
In 2006, Congress gave the academy $7.5 million through appropriations to create the Orthopaedic Trauma Research Program, which is using the money for grants relating to combat trauma — everything from using existing muscles to control prosthetic devices, to figuring out just how much flesh needs to be removed around a wound to prevent infection.
Some of the results have been surprising. Army Col. John Kragh Jr., an orthopedist at the Army Institute of Research at Fort Sam Houston, Texas, reported that using a tourniquet in combat results in amputation only 1 percent of the time. But people are often taught that they should use a tourniquet only as a last resort because it will result in an amputation.
Kragh argued that with proper monitoring and placement, that’s just not true.
And Navy Capt. Frank Butler, medical consultant to the Navy’s Medical Lessons Learned Center, said not using tourniquets has resulted in some deaths that were “potentially preventable.”
Army Col. Roman Hayda, acting chief of orthopedic services at Brooke Army Medical Center, gave a presentation about contamination and war wounds. He reported that recent studies show some irrigation methods — common practice for extremity wounds — may actually push infection further into a wound, and that more research needs to be done to find the best means to clean out a wound.
Ellie