Fasciotomy Rates in Operations Enduring Freedom and Iraqi Freedom: Association with Injury Severity and Tourniquet Use

@article{Kragh2011FasciotomyRI,
  title={Fasciotomy Rates in Operations Enduring Freedom and Iraqi Freedom: Association with Injury Severity and Tourniquet Use},
  author={John F. Kragh and Charles E. Wade and David G. Baer and John A. Jones and Thomas J. Walters and Joseph R. Hsu and Joseph Wenke and Lorne H. Blackbourne and John B. Holcomb},
  journal={Journal of Orthopaedic Trauma},
  year={2011},
  volume={25},
  pages={134-139}
}
Objective: To compare fasciotomy rates and Injury Severity Scores (ISSs) before and after tourniquets were fielded for combat casualties in March 2005. Methods: A military trauma registry was used to identify 4332 casualties with limb injury between 2003 and 2006. Descriptive statistics and regression analysis were used to compare changes in ISSs, limb Abbreviated Injury Scale (AIS) scores, and fasciotomy rates. An item of specific interest was whether changes in fasciotomy rates occurred… 
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34 Citations
Background Citations
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Methods Citations
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Results Citations
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34 Citations

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U.S. Military Experience From 2001 to 2010 With Extremity Fasciotomy in War Surgery.
TLDR
Over a decade of war, the survival rate of extremity injured casualties was associated with two trauma system interventions-tourniquet usage and a fasciotomy education program, and may be useful as a model for future attempted improvements in health care.
Early Fasciotomy and Limb Salvage and Complications in Military Lower Extremity Vascular Injury.
Comparison of military and civilian popliteal artery trauma outcomes.
Fasciotomy Improvement Through Recognition of Errors Course: A Focused Needs Assessment for Error Management Training for Lower Extremity Fasciotomy Performance.
Compartment syndrome performance improvement project is associated with increased combat casualty survival
TLDR
Combat casualty care following implementation of a fasciotomy education program was associated with improved survival, higher fAsciotomy rates, and fewer revisions.
Tourniquet use is not associated with limb loss following military lower extremity arterial trauma
TLDR
Field TK use is associated with wound infection and neurologic compromise but not limb loss, may be due to a more severe injury profile among TK limbs, and increased TK times may predispose to systemic, but not limbs, complications.
Acute Extremity Compartment Syndrome and the Role of Fasciotomy in Extremity War Wounds.
TLDR
Enhanced pre-deployment training of surgeons decreases the need for revision fasciotomy at higher echelons of care and should be continued in future conflicts, and the liberal use of prophylactic fAsciotomy prior to aeromedical evacuation and after limb reperfusion is recommended.
Tourniquet use for peripheral vascular injuries in the civilian setting.
Open Fracture Care During War: Opportunities for Research
TLDR
Preclinical and clinical translational studies on the reduction of the rates of infection and other limb morbidities are needed to address the acute care of combat extremity wounds.
Fasciotomy Reduces Compartment Pressures and Improves Recovery in a Porcine Model of Extremity Vascular Injury and Ischemia/Reperfusion
TLDR
A model of extremity compartment syndrome following vascular injury\hemorrhage and ischemia/reprovision and the effect of fasciotomy on measures of neuromuscular recovery is established.
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