ABSTRACT
A mangled face is an uncommon injury that can occur in a combat zone as a result of blunt trauma, penetrating trauma or explosion injury. Despite the patient?s dramatic disfigurement, attention needs to focus on the basic ABC?s of initial trauma management. We present an injured Afghan civilian with a severe facial injury. Our approach to airway management, breathing evaluation and hemorrhage control are described. In addition we utilized two emergency hemorrhage control modalities that are usually associated with other areas of the body, a circumferential compression sling and a laparotomy sponge packing.
Subject(s)
Airway Management , Emergency Medical Services , Facial Injuries/surgery , Hemostatic Techniques , Military Medicine , Adult , Afghanistan , Facial Injuries/etiology , Facial Injuries/pathology , Humans , Male , Soft Tissue Injuries/etiology , Soft Tissue Injuries/pathology , Soft Tissue Injuries/surgery , United StatesABSTRACT
Surgical excision of cancerous tumors and the human stress response can lead to metastasis of tumor cells. Furthermore, the medications used during the perioperative period (eg, opioids and anesthetic agents) have been shown to inhibit or suppress natural killer (NK) cell activity, one of the body's main defenses against spread of cancer. There are currently no anesthetic regimens that have been shown to completely reverse surgical stress-induced suppression of NK cell activity. However, there may be anesthetic techniques that attenuate surgical suppression of NK cell activity. This article reviews the effects of various anesthetics and analgesics on NK cell activity and suggests techniques to attenuate the suppressive effects of these compounds.
