Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Good outcomes with multiple limb salvage after severe combat injuries, reports Plastic and Reconstructive Surgery

30.07.2014

Experience shows no increase in complications, compared to single-limb salvage techniques

For survivors of severe combat injuries threatening more than one limb, reconstructive surgical procedures using tissue flaps have a good record of safety and effectiveness in avoiding amputation, reports a paper in the August issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Experience with multiple limb salvage procedures in solders injured in Iraq and Afghanistan shows good success rates, with no increase in complications compared to single-flap techniques, report Dr. Ian Valerio of Walter Reed National Military Medical Center and colleagues.

Encouraging Results with Multiple Limb Salvage Procedures

The researchers analyzed limb salvage procedures in military personnel sustaining combat-related injuries to multiple limbs while serving in Iraq and Afghanistan. "Limb salvage" refers to surgical reconstruction carried out to avoid amputation and maximize functioning of the surviving extremity.

From 2003 through 2012, a total of 359 limb salvage procedures were performed at the National Capital Consortium. Of these, 48 procedures involved attempts to salvage two or more injured limbs. "Critical to each of the cases presented in our series was maintenance of residual limb length and a functioning joint (wrist joint and knee joint)," Dr. Valerio and colleagues write.

The limb salvage procedures were performed an average of about one month after initial injury. About 90 percent of patients were injured by blasts from improvised explosive devices; about 60 percent of the threatened limbs were lower extremities (leg to foot). Injuries were more severe in the multiple-extremity salvage group, based on a standard scoring system.

Yet the overall complication rate was similar between groups: 26 percent for patients undergoing single-extremity salvage versus 33 percent in the multiple-limb group. This was so despite the use of additional tissue flaps for reconstruction in patients undergoing multiple-limb salvage.

With Improvements in Survival, Need for Advanced Reconstruction

The overall flap success rate was about 90 percent in both groups. Long-term amputation rates were similar as well. Complications related to one type of tissue flap (free flaps) were higher in the multiple limb-salvage group.

Advances in forward surgical care have increased the survivability of severe blast-related combat injuries. "The conflicts in Iraq and Afghanistan have highlighted a unique group of patients surviving multiple extremity war injuries complicated by open fractures requiring complex reconstruction," according to Dr. Valerio and coauthors.

The new study is one of the first to focus on the outcomes of limb-salvage procedures in these severely injured patients. For patients who may have already lost one or more limbs, preservation of the remaining limbs is "even more critical" to facilitate early ambulation (walking) as well as potentially optimizing rehabilitation and related activities of daily living goals after reconstruction, the authors note.

"Our experience supports limb salvage in the multiple extremity injured patients with avoidance of higher limb amputation levels, despite a higher injury severity score." Dr. Valerio and coauthors conclude. They hope their experience will contribute to further improving the outcomes of surgical reconstruction—and thus long-term rehabilitation and functioning—for survivors of severe and limb-threatening combat injuries.

###

Click here to read "Multiple Limbs Salvaged Using Tissue Transfers in the Same Casualty: A Cohort Comparison Study Chronicling a Decade of War-Injured Patients."

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About Plastic and Reconstructive Surgery

For more than 60 years, Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery®brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.

About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at http://www.plasticsurgery.org or http://www.facebook.com/PlasticSurgeryASPS and http://www.twitter.com/ASPS_news.

About Wolters Kluwer Health

Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries worldwide, clinicians rely on Wolters Kluwer Health's market leading information-enabled tools and software solutions throughout their professional careers from training to research to practice. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Ovid®, Pharmacy OneSource®, ProVation® Medical and UpToDate®.

Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2013 annual revenues of €3.6 billion ($4.7 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America. Follow our official Twitter handle: @WKHealth.

Connie Hughes | Eurek Alert!

Further reports about: ASPS Reconstructive Surgeons injuries limb limbs plastic reconstruction

More articles from Health and Medicine:

nachricht Stanford researchers observe the moment when a mind is changed
06.05.2015 | Stanford School of Engineering

nachricht UNC Team uses cellular bubbles to deliver Parkinson's meds directly to brain
05.05.2015 | University of North Carolina at Chapel Hill

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Spray drying the precision particle under the virtual magnifying glass

Spray drying is a common manufacturing process, used in the production of ceramic granulate for technical components or dental prostheses as well as dissolvable medicinal substances, food additives and in the processing of milk into powder. Using computer simulation methodology developed by scientists at the Fraunhofer Institute for Mechanics of Materials IWM, a more comprehensible understanding can now be gained of the behavior of particles in solvent during the spray drying process. This allows powder and granulate manufacturers to specifically adjust the properties of their products while reducing waste.

Previously, it was unusual for granule and powder producers to use granulation simulations to improve their products. For new product development or process...

Im Focus: The random raman laser: A new light source for the microcosmos

Texas A&M University researchers demonstrate how a narrow-band strobe light source for speckle-free imaging has the potential to reveal microscopic forms of life

In modern microscope imaging techniques, lasers are used as light sources because they can deliver fast pulsed and extremely high-intensity radiation to a...

Im Focus: Pulsar with widest orbit ever detected

Discovered by high school research team

A team of highly determined high school students discovered a never-before-seen pulsar by painstakingly analyzing data from the National Science Foundation's...

Im Focus: Erosion, landslides and monsoon across the Himalaya

Scientists from Nepal, Switzerland and Germany was now able to show how erosion processes caused by the monsoon are mirrored in the sediment load of a river crossing the Himalaya.

In these days, it was again tragically demonstrated that the Himalayas are one of the most active geodynamic regions of the world. Landslides belong to the...

Im Focus: Through the galaxy by taxi - The Dream Chaser Space Utility Vehicle

A world-class prime systems integrator and electronic systems provider known for its rapid, innovative, and agile technology solutions, Sierra Nevada Corporation (SNC) is currently developing a new space transportation system called the Dream Chaser.

The ultimate aim is to construct a multi-mission-capable space utility vehicle, while accelerating the overall development process for this critical capability...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Green Summit 2015: the summit of the essential

05.05.2015 | Event News

HHL Energy Conference on May 11/12, 2015: Students Discuss about Decentralized Energy

23.04.2015 | Event News

“Developing our cities, preserving our planet”: Nobel Laureates gather for the first time in Asia

23.04.2015 | Event News

 
Latest News

Expedition Genomics Lab: the mobile revolution in genetic analysis

06.05.2015 | Life Sciences

How noise changes the way the brain gets information

06.05.2015 | Life Sciences

A model approach for sustainable phosphorus recovery from wastewater

06.05.2015 | Ecology, The Environment and Conservation

VideoLinks
B2B-VideoLinks
More VideoLinks >>>