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Objective To develop a war wound database that is capable of data acquisition , audit, storage, query and statistical analysis,and can be used to record wounds, diagnosis,treatment and outcomes.Methods Based on requirement analysis and database design , the basic structure and function of this database system were determined before we developed this database system by Java on Oracle 11g.Results The database had eight data modules , including basic information , wounded information , wound conditions , first aid and treatment information , medication information , surgical information , medical evacuation , and operational background .The database management system ( DBMS ) was established , and the functions were ensured .Conclusion The records of war wound in the databases are highly continuous , timely, and standardized .They can adapt to the language of medical support research and war wound treatment research .
ABSTRACT
Introducción Las heridas de guerra, como las producidas por minas antipersona modificadas, generan lesiones extensas de los tejidos blandos y amputaciones traumáticas, intensamente contaminadas con tierra, vegetación, materia fecal e, incluso, tejidos de otras víctimas. El objetivo del estudio es establecer el tipo de microorganismos que se aíslan en este tipo de lesiones. Materiales y métodos Estudio descriptivo retrospectivo, del tipo serie de casos, realizado entre enero de 2012 y diciembre de 2014, en el cual se incluyó a todos los pacientes con heridas por proyectil de arma de fuego, armas de fragmentación o minas antipersona, que presentaban compromiso de tejido óseo, cultivos bacteriológicos óseos y/o tejidos blandos con reporte definitivo y pruebas de sensibilidad a los antibióticos en los gérmenes aislados. Resultados Se incluyó a 126 pacientes y se encontró que el 72% de estos presentaba una fractura abierta de gradoIIIA y el 25%, de grado IIIB. Las bacterias gramnegativas fueron las mayormente aisladas en cultivos (41%). Enterococcus faecalis fue la bacteria aislada con mayor frecuencia (15%), seguido por Pseudomonas aeruginosa (13%). Discusión Se puso de manifiesto que el 52% de los gérmenes aislados presentaba algún tipo de resistencia al manejo antibiótico empírico que se les aplica como protocolo en el momento del ingreso (cefalosporina+aminoglucósido y ciprofloxacino+clindamicina en caso de armas de fragmentación). Esto establece un nuevo reto médico y quirúrgico para todos los responsables del manejo integral de estos pacientes. Nivel de evidencia clínica Nivel III.
Background War injuries such as those produced by modified antipersonnel mines generate extensive soft tissue damage and traumatic amputations, which are severely contaminated with soil, vegetation, faecal components, and even the tissues of other victims. The objective of the study is to establish the type of microorganisms that are isolated in these types of injuries. Materials and methods A case series was conducted between January 2012 and December 2014, which included all patients with wounds from gunshots, fragmentation weapons, or antipersonnel mines, who had bone-tissue involvement, bacteriological cultures of bone and / or soft tissues with definitive reports, and antibiotic sensitivity tests on isolated germs. Results Of the126 patients included, it was found that 72% had an open fracture grade IIIA, and 28% a grade IIIB fracture. Gram negative bacteria were the most isolated in cultures (41%). Enterococcus faecalis was the most frequently isolated bacterium (15%), followed by Pseudomonas aeruginosa (13%). Discussion It was shown that 52% of isolated germs had some type of resistance to the empirical antibiotic management that was applied as a protocol at the time of admission (cephalosporin+aminoglycoside and ciprofloxacin+clindamycin in case of fragmentation weapons). This sets a new medical and surgical challenge for all those responsible for the integral management of these kinds of patients. Evidence level III.
Subject(s)
Humans , Antibiotic Prophylaxis , War-Related Injuries , Fractures, OpenABSTRACT
Objective To develop a liquid bandage for self aid of war wound.Methods Solution A and B were prepared containing functional polymers derived from the biocompatible poly (ethylene glycol) and hyaluronic acid,which had ability of fast crosslinking reaction when they were mixed.Among them,A solution mainly comprised of mercapto group-containing hyaluronic acid derivative (HA-SH),water-solubility starch,propylene glycol,benzoic acid and etc.B solution contained pentaerythritol tetraacrylate derivative (4arm-PEG-Acrylate) and benzoic acid.The structure of mercapto group-containing hyaluronic acid derivative was confirmed by IR,1H-NMR and etc.HA-SH and 4arm-PEG-Acrylate were formulated to different concentrations (W/V) in different buffers.The two kinds of solution were mixed in different ratios,and in situ crosslinking hyaluronic acid hydrogel was obtained;the crosslinking time was recorded.The adhesive force and waterholding capacity of the hydrogel after crosslinking were measured by adding excipients such as water-solubility starch.Results In case the concentration of HA-SH and 4arm-PEG-Acrylate was 2％ and pH value was 11,the hydrogel film on wound skin would be quickly formed in 20 seconds for wound dressing after spraying A and B solution onto the wound skin.Conclusion The liquid bandage has strong adhesive force,high water-holding capacity and controllable crosslinking time,so it could be used as a novel wound dressing for war wound.
ABSTRACT
Objective To explore the value of practicing PBL which was guided by MDT in teaching diagnoses and treatments of war wound and trauma caused by compound agents.Methods An emulational war wound case caused by compound factors was designed and a multi-disciplinary team been organized,then totally 45 interns who would graduate in 2017 were divide into two groups randomly,experimental group which had 23 cases received PBL model combined with MDT followed six step procedure which included case preparation by teachers,independent analysis and group discussion by interns,problem extraction by teachers and division of solution by interns before class,then answering and debating problems by interns in class,conclusion and reporting after class in the end,while the control group which had 22 cases received traditional teaching model in accordance with common case discussion in class including characteristics of patient,diagnosis and diagnostic basis,examinations needed to carry out,first aid measures and professional treatments.The effect of new teaching model was evaluated by assessment in class and questionnaire after class.The data was analyzed through Chi-square test by SPSS 22.0.Results Class assessment showed 18 (78.3％) interns in experimental group displayed good abilities of proposing,analyzing and resolving medical problem,as well as good presentation and speech skills.Questionnaire survey showed that not only clinical teaching of war wound and trauma could meet the demands of talent training in battle-field rescue,but also displayed new model,which could help interns to enhance abilities of first-aid and treatment of war wound on future war field,reinforce the consciousness of military medical support and service.In addition,it could clear confusion more professionally and strengthen teamwork and overall importance.Conclusion Applying PBL combined with MDT in teaching diagnoses and treatments of war wound and trauma can not only help interns to review and retain important knowledge of related subjects,but also improve the abilities of interns in clinical diagnoses and treatments,and moreover,it merges the medical knowledge and war wound cure together organically.In short,the new model is well worth applying in clinical teaching and military medical education because of its excellent effects.