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. 2011 Jan 27;366(1562):219-30.
doi: 10.1098/rstb.2010.0237.

Shaping the military wound: issues surrounding the reconstruction of injured servicemen at the Royal Centre for Defence Medicine

Demetrius Evriviades  1 , Steven Jeffery, Tania Cubison, Graham Lawton, Martin Gill, Deborah Mortiboy
Affiliations

Shaping the military wound: issues surrounding the reconstruction of injured servicemen at the Royal Centre for Defence Medicine

Demetrius Evriviades et al. Philos Trans R Soc Lond B Biol Sci. .

Abstract

The conflict in Afghanistan has produced injuries similar to those produced from military conflicts for generations. What distinguishes the modern casualty of the conflict in Afghanistan from those of other conflicts is the effectiveness of modern field medical care that has led to individuals surviving with injuries, which would have been immediately fatal even a few years ago. These patients present several challenges to the reconstructive surgeon. These injured individuals present early challenges of massive soft-tissue trauma, unstable physiology, complex bony and soft-tissue defects, unusual infections, limited reconstructive donor sites, peripheral nerve injuries and traumatic amputations. Late challenges to rehabilitation include the development of heterotopic ossification in amputation stumps. This paper outlines the approach taken by the reconstructive team at the Royal Centre for Defence Medicine in managing these most difficult of reconstructive challenges.

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Figures

Figure 1.
Figure 1.
Typical presentation of IED blast lower limb injury: high above-knee amputations with inadequate skin coverage, complex defect of perineum, urethral defect and bilateral traumatic orchidectomy.
See this image and copyright information in PMC

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