scholarly journals Surgical Services and Transformation of Civil Hospital During “August War 2008” in Georgia

2011 ◽  
Vol 96 (1) ◽  
pp. 1-5 ◽  
Author(s):  
M. A. Kiladze ◽  
N. G. Lominadze ◽  
V. T. Goderdzishvili ◽  
G. I. Kcherodinashvili ◽  
T. I. Mgeliashvili ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Damage Control ◽  
Neck Region ◽  
Hemorrhage Control ◽  
Civil Hospital ◽  
Surgical Services ◽  
Combined Operations ◽  
Short Period ◽  
Surgery Department ◽  
Combat Casualties

Abstract Structural transformation of a civil hospital into a military one during “August War 2008” (August 8–12) in Georgia is presented. Damage-control principles, such as hemorrhage control, liver-packing and abdominal tamponade, gastrointestinal tract resection without formation of anastomoses, and other temporary interventions were prioritized. This provided a chance to empty the hospital in a short period to provide the admission of an increased number of combat casualties. There were soldiers from Georgian troops, civilians, and captives of war. The number of total admitted patients was 739. Fifty-two patients were operated on in the surgery department. The following operations were carried out: removal of foreign bodies from the neck region, 6 cases; isolated thoracotomy, pulmorrhaphy, and drainage, 2 cases; laparotomy, hepatorrhaphy, gastrorrhaphy, splenectomy, resection of small intestine, and colostomy, 18 cases; combined operations (thoracotomy plus laparotomy), 9 cases; extended debridement and dressing of wounds, 11 cases; angiosurgical operations, 4 cases; and coloplasty, 2 cases. There were 2 cases of mortality, 1 case of rethoracotomy, and 3 cases of relaparotomy: 2 because of intracavital bleeding and 1 because of sanation.

scholarly journals Prevalence of Head and Neck Cancer in the State of Meghalaya: Hospital-based Study

2013 ◽  
Vol 4 (1) ◽  
pp. 1-5
Author(s):  
Neizekhotuo Brian Shunyu ◽  
Judita Syiemlieh
Keyword(s):  
Head And Neck Cancer ◽  
Retrospective Study ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Neck Region ◽  
The State ◽  
Civil Hospital ◽  
High Prevalence ◽  
Total Body

ABSTRACT In India, 20 to 40% of all cancer arises in the head and neck region. The highest rate is seen in the eastern and southern regions of our country. The alarming high prevalence of head and neck cancer (HNC) in this region has prompted us to undertake this retrospective study. This study is to give the picture on the prevalence of HNC in the region, as such studies are lacking, till date. This is a 5 years retrospective study of cancer patients from 2007 to 2011 who have been registered in Civil Hospital, Shillong. The period of study is short as registry before 2007 was not properly recorded, but the high prevalence of cancer especially HNC warranted the need to undertake this retrospective study. During the 5-year period, there were a total of 3,123 cancer patients, registered in Civil Hospital, Shillong. In this study, HNC and esophageal cancer constitute 2,207 (70.67%) cases of the total body malignancy (TBM) which is much higher than other studies done in other parts of the country. Fourth decade is the most common age group comprising of 471 cases which accounts for 32.72% of all HNC. This high prevalence of HNC in the young population of the region is alarming and hence needs a comprehensive afford to meet this challenge. This paper, therefore, is an attempt to quantify the spectrum of HNC in the region hoping that this paper will help the health professionals to understand the burden of HNC in the region, so as to generate strategies for future planning. How to cite this article Shunyu NB, Syiemlieh J. Prevalence of Head and Neck Cancer in the State of Meghalaya: Hospital-based Study. Int J Head and Neck Surg 2013;4(1):1-5.

Transfusion Therapy

2017 ◽  
Author(s):  
Ronald Chang ◽  
John B. Holcomb
Keyword(s):  
Damage Control ◽  
Scientific Evidence ◽  
Hemorrhage Control ◽  
Transfusion Therapy ◽  
Trauma Induced Coagulopathy ◽  
Primary Means ◽  
Underlying Mechanisms ◽  
Trauma Deaths ◽  
Traumatic Hemorrhagic Shock ◽  
Traumatic Hemorrhage

Exsanguination occurs rapidly after trauma (median 2 to 3 hours after admission) and is the leading cause of preventable trauma deaths. The modern treatment for traumatic hemorrhagic shock is simultaneous mechanical hemorrhage control and damage control resuscitation (DCR), which emphasizes using plasma as the primary means for volume expansion. Other core DCR principles include minimization of crystalloid, permissive hypotension, and goal-directed resuscitation. The treatment of traumatic hemorrhage is complicated by trauma-induced coagulopathy (TIC); DCR is thought to address TIC directly despite incomplete understanding of the underlying mechanisms. Recent data point to a 1:1:1 ratio of plasma and platelets to red blood cells as the optimal blood product ratio for acute traumatic hemorrhage. However, this paradigm may soon be supplanted by a transition back to whole blood. Although it is intuitive to apply these same protocols and algorithms to patients with nontraumatic hemorrhage, the scientific evidence is lacking. Key words: endotheliopathy, hemorrhage, massive transfusion, trauma-induced coagulopathy

Transfusion Therapy

2017 ◽  
Author(s):  
Ronald Chang ◽  
John B. Holcomb
Keyword(s):  
Damage Control ◽  
Scientific Evidence ◽  
Hemorrhage Control ◽  
Transfusion Therapy ◽  
Trauma Induced Coagulopathy ◽  
Primary Means ◽  
Underlying Mechanisms ◽  
Trauma Deaths ◽  
Traumatic Hemorrhagic Shock ◽  
Traumatic Hemorrhage

Exsanguination occurs rapidly after trauma (median 2 to 3 hours after admission) and is the leading cause of preventable trauma deaths. The modern treatment for traumatic hemorrhagic shock is simultaneous mechanical hemorrhage control and damage control resuscitation (DCR), which emphasizes using plasma as the primary means for volume expansion. Other core DCR principles include minimization of crystalloid, permissive hypotension, and goal-directed resuscitation. The treatment of traumatic hemorrhage is complicated by trauma-induced coagulopathy (TIC); DCR is thought to address TIC directly despite incomplete understanding of the underlying mechanisms. Recent data point to a 1:1:1 ratio of plasma and platelets to red blood cells as the optimal blood product ratio for acute traumatic hemorrhage. However, this paradigm may soon be supplanted by a transition back to whole blood. Although it is intuitive to apply these same protocols and algorithms to patients with nontraumatic hemorrhage, the scientific evidence is lacking. Key words: endotheliopathy, hemorrhage, massive transfusion, trauma-induced coagulopathy

Transfusion Therapy

2018 ◽  
Author(s):  
Ronald Chang ◽  
John B. Holcomb
Keyword(s):  
Damage Control ◽  
Scientific Evidence ◽  
Hemorrhage Control ◽  
Transfusion Therapy ◽  
Trauma Induced Coagulopathy ◽  
Primary Means ◽  
Underlying Mechanisms ◽  
Trauma Deaths ◽  
Traumatic Hemorrhagic Shock ◽  
Traumatic Hemorrhage

Exsanguination occurs rapidly after trauma (median 2 to 3 hours after admission) and is the leading cause of preventable trauma deaths. The modern treatment for traumatic hemorrhagic shock is simultaneous mechanical hemorrhage control and damage control resuscitation (DCR), which emphasizes using plasma as the primary means for volume expansion. Other core DCR principles include minimization of crystalloid, permissive hypotension, and goal-directed resuscitation. The treatment of traumatic hemorrhage is complicated by trauma-induced coagulopathy (TIC); DCR is thought to address TIC directly despite incomplete understanding of the underlying mechanisms. Recent data point to a 1:1:1 ratio of plasma and platelets to red blood cells as the optimal blood product ratio for acute traumatic hemorrhage. However, this paradigm may soon be supplanted by a transition back to whole blood. Although it is intuitive to apply these same protocols and algorithms to patients with nontraumatic hemorrhage, the scientific evidence is lacking. Key words: endotheliopathy, hemorrhage, massive transfusion, trauma-induced coagulopathy

scholarly journals Rectal Foreign Body in a 30 Year Old Male- A Case Report

2018 ◽  
Vol 9 (1) ◽  
pp. 35-37
Author(s):  
Md Monoarul Islam Talukdar ◽  
Quamrul Akter ◽  
Md Abdullah Al Mamun ◽  
Abdullah Md Abu Ayub Ansary
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Young Male ◽  
College Hospital ◽  
Rectal Pain ◽  
Medical College ◽  
Post Operative Period ◽  
Abdominal Radiographs ◽  
Early Decision ◽  
Surgery Department

Though anorectal foreign body cases are rare, they have become increasingly frequent in recent years. Although entrapped foreign bodies are most often related to sexual behavior, they can also result from ingestion or sexual assault. The diagnosis may be made by rectal examination and metallic objects can be confirmed by plain abdominal radiographs. Transanal removal is only possible for very low-lying objects, while patients with high-lying foreign bodies usually require an operative intervention. An early decision of laparotomy should only be made after subjecting the patient to suitable investigations to determine exact location of the object, in order to avoid any inadvertent damage to the adjoining vasculature as well as anal incontinence. . We report the case of a young male who presented at surgery department of Shaheed Suhrawardy medical college hospital with severe rectal pain due to insertion of an apple into rectum by some eunuchs. It was successfully removed transanally under spinal anesthesia. Post operative period was uneventful and referred for psychiatric consultation.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 35-37

Retained Foreign Bodies after Emergent Trauma Surgery: Incidence after 2526 Cavitary Explorations

2007 ◽  
Vol 73 (10) ◽  
pp. 1031-1034 ◽  
Author(s):  
Pedro G.R. Teixeira ◽  
Kenji Inaba ◽  
Ali Salim ◽  
Carlos Brown ◽  
Peter Rhee ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Damage Control ◽  
Trauma Surgery ◽  
Radiographic Evaluation ◽  
Trauma Patients ◽  
X Rays ◽  
Chest X Ray ◽  
Cavity Closure ◽  
Level 1 Trauma Center

Trauma patients are thought to be at high risk for iatrogenic retained foreign bodies (RFBs). The objective of this study was to evaluate this incidence. All cases of RFB after cavitary trauma surgery were identified by review of Morbidity and Mortality reports at a Level 1 trauma center from January 1998 to December 2005 and confirmed by the Octagon Risk Management System. Over 8 years, 10,053 trauma operations were performed (2075 laparotomies, 377 thoracotomies, and 74 sternotomies). Three cases (0.1%) of RFB (all sponges) occurred during one single-stage and two damage control laparotomies. The counts were correct before definitive closure in two of three cases. No postoperative x-rays were obtained in any of the cases. RFB diagnosis occurred between days 3 and 9, one on a routine chest x-ray and the other two on abdominal computed tomography scans during a septic workup. Four-month to 8-year follow up documented one pleural effusion and one abscess resulting from the RFB. Iatrogenic RFBs after emergent cavitary trauma surgery occur at a rate of 0.12 per cent and are associated with significant morbidity. In addition to standard preventive strategies, in emergent cases with risk factors such as requiring damage control, before final cavity closure, even with a correct sponge count, radiographic evaluation is warranted.

scholarly journals The Evolution of Damage Control in Concept and Practice

2017 ◽  
Vol 31 (01) ◽  
pp. 030-035 ◽  
Author(s):  
Brian Beldowicz
Keyword(s):  
Medical Decision Making ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Strategy Implementation ◽  
Medical Decision ◽  
Metabolic Dysfunction ◽  
Damage Control Resuscitation ◽  
Hemorrhage Control ◽  
Threat To Life ◽  
Critically Ill Surgical Patients

AbstractDamage control surgery (DCS) began as an adjunct approach to hemorrhage control, seeking to facilitate the body's innate clotting ability when direct repair or ligation was impossible, but it has since become a valuable instrument for a broader collection of critically ill surgical patients in whom metabolic dysfunction is the more immediate threat to life than imminent exsanguination. Modern damage control is a strategy that combines the principles of DCS with those of damage control resuscitation. When used correctly, damage control may improve survival in previously unsalvageable patients; when used incorrectly, it can subject patients to imprudent risk and contribute to morbidity. This review discusses the evolution of damage control in both concept and practice, summarizing available literature and experience to guide patient selection, medical decision-making, and strategy implementation throughout the preoperative, intraoperative, and early postoperative periods.

scholarly journals The Damage Control Resuscitation and Surgical Team: The New French Paradigm for Management of Combat Casualties

2020 ◽  
Author(s):  
Antoine Luft ◽  
Pierre Pasquier ◽  
Emmanuel Soucanye de Landevoisin ◽  
Nelly Morel-Stum ◽  
Arthur Baillon ◽  
...  
Keyword(s):  
Task Force ◽  
Damage Control ◽  
Lessons Learned ◽  
Technical Equipment ◽  
Damage Control Resuscitation ◽  
Surgical Team ◽  
Life Saving ◽  
The Creation ◽  
Combat Casualties ◽  
Surgical Unit

ABSTRACT Introduction The aim of this work was to introduce the new French forward resuscitation and surgical unit. It’s also to discuss the choices and waivers granted to fit the tactical context of modern conflicts and the current epidemiology of combat casualties. Materials and Methods A multidisciplinary task force of 11 people proceeded to the conception and the creation of a new military resuscitation and surgical unit. The preliminary work included a scoping review of the combat casualties’ epidemiology in modern conflicts and an analysis of the recent French medical–surgical treatment facilities lessons learned. In April 2019, a technical–operational evaluation was conducted to confirm all the technical, ergonomic, and organizational choices made during the design phase. Results The multidisciplinary task force resulted in the creation of the Damage Control Resuscitation and Surgical Team (DCRST). The DCRST focused on the resuscitation strategy, including transfusion of blood products, and the life-saving surgical procedures to be performed as close as possible to the point of injury. It was designed for the resuscitation of two patients: the life-saving surgery of two patients and the very short-term intensive care (<12 hours) of four patients at the same time. The DCRST provided sufficient autonomy to provide take care of four T1 and four T2 or T3 casualties per day for 48 hours. It was armed with 23 soldiers. The technical equipment represented 5,300 kg and 27 m3. All the technical medical equipment could be stored in two 20-foot containers. Conclusion The DCRST represents a new paradigm in medical support of French military operations. It offers the advantage of two combat casualties’ surgical management at the same time, as close as possible to the combat zone. It responds to a 2-fold epidemiological and logistical challenge.

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