Effects of Prehospital Wound Prophylaxis in Iraq and Afghanistan on Mortality

  title={Effects of Prehospital Wound Prophylaxis in Iraq and Afghanistan on Mortality},
  author={Jason F. Naylor and Kimberly M. Burbank and Michael David April and Joseph Wenke and Joseph K. Maddry and Steven G. Schauer},
  journal={Journal of trauma and treatment},
Introduction: A significant proportion of traumatic injuries sustained during the recent conflicts in Afghanistan and Iraq developed subsequent wound infections. Previous studies demonstrate lower infectious rates with timely administration of antibiotics, but do not evaluate impact on mortality. We compare demographics, injury characteristics, and survival rates among adult combat casualties receiving prehospital wound prophylaxis versus casualties not receiving antibiotic prophylaxis.Methods… 
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There was a rapid decline in combat casualty volumes since 2014, however, on a per-encounter basis there was no apparent drop in procedural volume.



Impact of Operational Theater on Combat and Noncombat Trauma-Related Infections.

The difference in infection rates between operational theaters is primarily a result of increased injury severity in Afghanistan from a higher proportion of blast-related trauma during the study period.

Osteomyelitis in military personnel wounded in Iraq and Afghanistan.

The microbiology of osteomyelitis in veterans of OIF/OEF differs substantially depending upon whether the infection is new or recurrent, despite nearly universal use of gram- positive therapy.

Combat wounds in operation Iraqi Freedom and operation Enduring Freedom.

The wounding patterns currently seen in Iraq and Afghanistan resemble the patterns from previous conflicts, with some notable exceptions: a greater proportion of head and neck wounds, and a lower proportion of thoracic wounds.

Early Complications and Outcomes in Combat Injury–Related Invasive Fungal Wound Infections: A Case–Control Analysis

The analysis indicates that IFIs adversely impact wound healing and patient recovery, requiring more frequent proximal amputation revisions and leading to higher early complication rates.

Eliminating preventable death on the battlefield.

A command-directed casualty response system that trains all personnel in Tactical Combat Casualty Care and receives continuous feedback from prehospital trauma registry data facilitated performance improvements that resulted in unprecedented reduction of killed-in-action deaths, casualties who died of wounds, and preventable combat death.

Infectious disease complications of combat-related injuries

Many of the management strategies used to prevent infections of combat-related injuries are applicable to the management of civilian trauma, whether associated with small arms fire or related to natural disasters such as earthquakes or tornadoes.

Demographics, treatment, and early outcomes in penetrating vascular combat trauma.

There is an acceptable early patency and limb salvage rate in combat vascular repairs and overall, penetrating vascular trauma is often a survivable injury.

Characterization of Extremity Wounds in Operation Iraqi Freedom and Operation Enduring Freedom

The burden of wounds sustained in OIF/OEF is extremity injuries, specifically soft-tissue wounds and fractures, which are similar to the reported casualties from previous wars.

Evaluating the Joint Theater Trauma Registry as a data source to benchmark casualty care.

Data contained in the JTTR were found to be suitable for establishing benchmarks for 24-hour mortality in casualties with polytrauma and a moderate or severe blunt traumatic brain injury (TBI).