Experience in treating combat burns in Afghanistan by using silver-nylon dressing.

BACKGROUND: On the battlefield, insidious and devastating weapons like the improvised explosive device (IED) rapidly emit extreme heat (thousands of degrees), create a shock wave (overpressure) that can hurl bodies long distances (inducing secondary fall lesions), and deliver thousands of pieces of shrapnel over hundreds of meters. MATERIALS AND METHODS: Very often, Soldiers injured by an IED blast are inside their vehicle. Subsequently, they are exposed to the thermal effects of the blast. Frequently, these patients have complex wounds that consist of extensive burn areas, bone fractures, and internal organ lesions. The use of silver-nylon burn wrap dressing is widely documented for its bactericidal properties. Silverlon® Burn Dressings is an elastic bandage made of nylon and plated with pure metallic silver. RESULTS: In summer 2008, in a U.S. advanced Role 2 facility, two U.S. Soldiers with extensive second- and third-degree burn injuries were successfully treated with the use of Silverlon Burn Dressings and Silverlon® Burn Gloves. CONCLUSIONS: From this experience emerged the ease of use silver-nylon dressing in treating badly burned Soldiers on the battlefield.

Surgical approach to intramyocardial administration of bone marrow stem cells in an animal model.

AIM: The aim of the study was to evaluate the surgical approach to intramyocardial (i.m.) injection of Bone Marrow Stem Cells (BMSCs) in a pre-clinical model and its complications. MATERIAL OF STUDY: In New Zealand rabbits an ischemia reperfusion injury lasting 20 min was induced by temporary ligation of anterior descending coronary artery during cardiac surgical procedure. Homologous BMSCs were isolated from the posterior iliac crest, cultured and re-suspended for injection. BMSC were injected at the peri-infarcted area and side effects were evaluated. A control group with myocardial infarction was treated with i.m. injections of saline, to evaluate possible side effects of injection. Comparison of ventricular premature contractions (VPC), ventricular tachycardia and ventricular fibrillation were recorded during surgery and after 7 and 21 days. RESULTS: Seven rabbits developed intractable ventricular fibrillation during the experimental protocol, three during coronary ligation but before cell injections and four following i.m. injections. At day 7, hourly PVC were more frequent in the groups of animals that received i.m. injections of BMSCs (132 ± 19 beats) compared to saline injections. (54 ± 14). CONCLUSIONS: Intramyocardial injections of BMSCs induced an electrical instability as shown by a high number of PVC as compared with intramyocardial injections of saline.

Emergency intraosseous access: a useful, lifesaving device used in afghanistan.

Intraosseous access is becoming a lifesaving procedure under emergency conditions in Afghanistan?s battlefield. The EZ-IO system (Vidacare, San Antonio, TX, USA) was successfully used in five patients in whom there was difficulty finding a peripheral venous access. The EZIO is an indispensable medical device to be used on the battlefield and during the evacuation of the wounded in a moving vehicle or helicopter.

Celox (chitosan) for haemostasis in massive traumatic bleeding: experience in Afghanistan.

The use of Celox, a chitosan-based haemostatic agent, for the control of massive traumatic bleeding in patients arriving at a ROLE 2 (Enhanced Care) Facility in southwestern Afghanistan is described. Twenty-one soldiers with gunshot wounds were treated with successful haemostasis in 18 at the first application and in three after further applications. Celox is an effective haemostatic agent and a useful adjunct for the treatment of massive traumatic bleeding.