ABSTRACT
BACKGROUND: The 7th Airborne Forward Surgical Team (FST) has deployed to Chad in 2015 and 2016, in support of French military forces. Humanitarian surgical care is known to represent a significant part of the surgical activity in such missions, but to date limited data have been published on the subject. METHODS: All surgical patients from a civilian host population treated by the FST during these missions have been prospectively included. Indications, operative outcomes and postoperative outcomes were evaluated. RESULTS: During this period, the FST operated on 358 patients. Humanitarian surgical care represented 95% of the activity. Most patients (92.7%) were operated for elective surgery. Emergencies and infectious diseases represented, respectively, 7.3% and 9.1% of cases. The mean length of stay (LOS) was three days (2-4), and the median follow-up was 30 days (22-34). Mortality rate was 0.6% and morbidity was 5.6%. Parietal surgery had no significant complication and had shorter LOS (p<0.001). Emergent surgeries were more complicated (p<0.01) and required more reoperations (p<0.05). Surgical infectious cases had longer LOS (p<0.01). CONCLUSIONS: Humanitarian surgical care can be provided without compromising the primary mission of the medical forces. Close surveillance and follow-up allowed favourable outcomes with low morbidity and mortality rates. Humanitarian care is responsible for a considerable portion of the workload in such deployed surgical teams. Accounting for humanitarian care is essential in the planning and training for such future medical operations.
Subject(s)
Elective Surgical Procedures/statistics & numerical data , Military Personnel , Surgical Procedures, Operative/statistics & numerical data , Uncompensated Care/statistics & numerical data , Adolescent , Adult , Chad/epidemiology , Developing Countries , Female , Follow-Up Studies , France , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Postoperative Complications/epidemiology , Prospective Studies , Young AdultABSTRACT
The aim of this study was to determine if pisotriquetral instability is present after neurolysis of the median nerve in the wrist. Fifty-five patients who underwent carpal tunnel release between December 2005 and March 2009 were included in this retrospective study. The surgical procedure consisted of cutting the transverse carpal ligament under local anesthesia through an anterior approach. Instability was evaluated clinically and radiologically by measuring the pisometacarpal angle. The mean patient age was 61years and the mean follow-up 42months. Only 9% of patients complained of pain on the ulnar side of wrist. The pisometacarpal angle in all the operated wrists was the same as in the non-operated wrists. Our findings suggest there is no pisotriquetral instability after median nerve neurolysis.
Subject(s)
Carpal Joints , Carpal Tunnel Syndrome/surgery , Joint Instability/etiology , Median Nerve/surgery , Postoperative Complications/etiology , Female , Humans , Male , Middle Aged , Pisiform Bone , Retrospective Studies , Triquetrum BoneABSTRACT
Comminuted articular fractures of the fingers are a real surgical challenge. Many surgical treatments are proposed, but despite their complexity, their results are often unsatisfactory. We describe a simple and functional treatment intended to ensure these articular fractures heal in the right position. The material used in this technique is inexpensive and easily available.
Subject(s)
Finger Injuries/therapy , Fractures, Comminuted/therapy , Intra-Articular Fractures/therapy , Bandages , Humans , Traction/methodsABSTRACT
Sera from different vertebrate species were tested for their stimulating activity upon mouse CFU-E growth. Crude sera were either naturally stimulating or toxic. Absorption on mouse blood and spleen cells or decomplementation removes or neutralizes the toxicity, probably mediated through natural anti-mouse antibodies. All but 2 sera tested (ox and sheep) were stimulatory. This stimulating activity was found to be either heat-sensitive or -resistant according to the sera. Upon chromatography on DEAE cellulose, 2 fractions were obtained which were both stimulatory. Whether these two stimulating activities correspond to different molecules or to only 1 absorbed on different serum proteins remains to be determined. These results confirm previous results obtained for mouse and human sera and suggest that this cross-reactive stimulating activity may have an important role in vertebrate erythropoiesis.
