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2010 ; 66
(4
): 350-3
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Reconstruction in Warfare Injuries
#MMPMID27365741
Langer V
Med J Armed Forces India
2010[Oct]; 66
(4
): 350-3
PMID27365741
show ga
Traumatic injuries, especially in the combat setting, stress the surgical team
that may be sited in a remote forward area, battling against paucity of time,
resources and infrastructure. The lone surgeon may be faced with the arduous
challenge of saving life. There is seldom thought given to reconstruction in this
high-pressure situation. If the patient survives, morbidity for want of
reconstruction can be severe and quality of life can suffer significantly.
Reconstruction after 3 to 5 days is fraught with complications and usually does
compromise outcome in the post-operative phase. The reconstructive surgeon should
be involved early in the management as he can provide coverage for large soft
tissue defects after aggressive debridement with panache. If the patient is
haemodynamically stable, he should be transferred urgently, preferrably by air,
to a higher centre with multi-specialty care, especially being equipped with an
orthopaedic and trauma reconstructive surgeon. It has been proved beyond doubt
that the healing improves significantly and there is marked decrease in morbidity
if coverage of wounds is provided early, before colonized wounds get infected.
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