The majority of US combat casualty soft-tissue wounds are not infected or colonized upon arrival or during treatment at a continental US military medical facility - 19/08/11
, Paul Keiser, M.D. d, David W. Craft, Ph.D. d, Fred Gage, B.S. a, b, Martin Robson, M.D. e, Trevor S. Brown, Ph.D. b, Kyle Petersen, D.O. f, Stephanie Sincock, Ph.D. g, Matt Kasper, Ph.D. g, Jason Hawksworth, M.D. b, h, Doug Tadaki, Ph.D. b, c, Thomas A. Davis, Ph.D. b, Alexander Stojadinovic, M.D. h, Eric Elster, M.D. a, b, c
Corresponding author. Tel.: +301-319-7367; fax: +301-319-7210Abstract |
Background |
The microbiology of war wounds has changed as medicine and warfare have evolved. This study was designed to determine the microbial flora and bacterial quantification of present-day war wounds in US troops from Iraq and Afghanistan upon arrival at the National Naval Medical Center (NNMC).
Methods |
Patients with extremity combat wounds treated with a vacuum-assisted wound closure device were enrolled in study. Wounds were biopsied every 48 to 72 hours with quantitative microbiology performed on all biopsies.
Results |
Two hundred forty-two wound biopsies from 34 patients; 167 (69%) showed no growth, and 75 (31%) showed positive growth. The incidence of any bacterial isolation from biopsies weekly from the time of injury was 28% (first), 31% (second), and 37% (≥third). Acinetobacter baumannii was the most prevalent isolate.
Conclusions |
Most soft-tissue wounds from Iraq and Afghanistan do not have significant bacterial burden upon arrival to and during initial treatment at NNMC. Improved evaluation of combat wound microbiology at all levels of care is warranted to determine shifts in microbiology and to impact care practices.
Le texte complet de cet article est disponible en PDF.Keywords : Combat extremity wounds, Combat soft-tissue wounds, Vacuum-assisted wound closure, Device, Microorganisms
Plan
| The views expressed in this manuscript are those of the authors and do not reflect the official policy of the Department of the Army, Department of the Navy, the Department of Defense or the US Government. We are a military service members (or employee of the US Government). This work was prepared as part of our official duties. Title 17 U.S.C. 105 provides the “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. 101 defines a US Government work as a work prepared by a military service member or employee of the US Government as part of that person's official duties. |
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| Supported in part by the US Navy Bureau of Medicine and Surgery under the Medical Development Program (PE 0604771N) and Office of Naval Research work unit number: 604771N.0933.001.A0604. This study was approved by the National Naval Medical Center Institutional Review Board in compliance with all Federal regulations governing the protection of human subjects. |
Vol 200 - N° 4
P. 489-495 - octobre 2010 Retour au numéro
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