![]() ![]() Surgical debridement of injured service members on the active battlefield is logistically difficult. In contrast, patients who receive surgical debridement and skin grafting can heal within 7–10 days and have a reduced risk of infection, scarring, and physical disability. 1 Although some deep partial-thickness (DPT) and full-thickness burns heal without surgical intervention, these wounds can take 3 weeks or longer to heal and can be complicated by infections, hypertrophic scars, and contractures. The current gold standard of care (GSOC) for severe burns is to debride the burned area by sharp excision to healthy bleeding tissue and to provide subsequent skin grafting. ![]() 6 Unfortunately, future combat will be more remote without the ability to evacuate or efficiently replenish medical units and supplies. The “Golden Hour” policy introduced by the Department of Defense in 2009 pushed for rapid life-saving evacuation of injured soldiers, given the ability of military forces to provide airlift capacity. 3, 6 Under the guidelines of tactical combat casualty care (TCCC), burn victims with burns greater than 20% of total body surface (TBSA) should be urgently transported to facilities that provide definitive medical care within 1–2 hours. air superiority, and modern weapons are more likely to cause large burns and wounds that are extremely difficult to treat. 4 Rising military powers of near-peer adversaries will challenge U.S. 4, 5 Burns accounted for 5% of the casualties evacuated in both OIF and OEF, and 2%–10% of casualties in the Persian Gulf, Afghanistan, Tajikistan, and Chechnya conflicts. 3 Combined data from the Joint Theater Trauma Registry, Navy/Marine Combat Trauma Registry, and the Armed Forces Medical Examiner System Mortality Trauma Registry indicate that nearly 80% of the 40,000 injuries sustained on the battlefield during Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) involved thermal injuries. 1, 2 Compared to civilians, deployed service members are twice as likely to suffer a burn injury. Endpoints included burn wound progression, re-epithelialization, wound contraction, scar elevation index, and colony-forming units (CFU).īurn injuries, both combat and noncombat, account for nearly 5%–20% of all casualties in modern warfare. Assessments were conducted using a combination of photographs, histology, and quantitative bacteriology. ![]() Wounds were serially assessed on post-burn days 3, 7, 14, 21, and 28. The 5 randomized OTS therapies were: irradiated sterile human skin allograft (IHS), biodegradable temporizing matrix (BTM), polylactic acid skin substitute, hyaluronic acid ester matrix (HAM), and decellularized fish skin graft (FSG). The remaining 6 burns were treated with 1% silver sulfadiazine cream (Ascend Laboratories, LLC, Parsippany, NJ) as the PFC standard of care (SOC) controls. ![]() Animals were then randomized into 5 experimental groups, and OTS therapies were applied to 6 of the 12 created DPT burns. Nonsurgical debridement was done 1-hour after burn creation using sterile saline water and gauze to remove excess eschar tissue. Deep partial-thickness (DPT) burns (25 cm 2) were created on the dorsum of 5 anesthetized pigs utilizing a thermocouple burn device at 100☌ for 15 seconds. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |