Abstract：
BACKGROUND:Currently, the open abdomen technique is the widely recognised method for treatment of life-threatening trauma, intra-abdominal sepsis, abdominal compartment syndrome and wound dehiscence. The techniques for temporary closure using negative pressure have gained increasing popularity. Although negative pressure wound therapy has been proved as an effective method in trauma, the results in diffuse peritonitis are contradictory. METHODS:Overall, 108 patients with diffuse peritonitis and open abdomen were prospectively enrolled from January 2006 to December 2013--69 treated with mesh-foil laparostomy without negative pressure and 49 with vacuum-assisted closure (VAC(®)) The primary endpoints were the rate of primary fascial closure and mortality. The secondary outcomes were the rate of complications--enteroatmospheric fistulas, intra-abdominal abscesses, wound infection and necrotising fasciitis, intensive care unit (ICU) and overall hospital stay. RESULTS:VAC was associated with higher overall (73% vs 53%) and late primary fascial closure rates (31% vs 7%), lower rates of necrotising fasciitis (2% vs 15%, p=0.012), intra-abdominal abscesses (10% vs 20%), enteroatmospheric fistulas (8% vs 19%), overall mortality (31% vs 53%, p<0.05), shorter ICU (6.1 vs 10.6 days, p=0.002) and hospital stay (15.1 vs 25.9 days, p=0.000). CONCLUSIONS:The results clearly suggest the obvious advantage of VAC in comparison to the temporary abdominal closure without negative pressure in the cases with severe diffuse peritonitis. However, to a large extent, our results might be attributed to the combination of VAC with dynamic fascial closure.
journal_name
J R Army Med Corpsjournal_title
Journal of the Royal Army Medical Corpsauthors
Mutafchiyski VM,Popivanov GI,Kjossev KT,Chipeva Sdoi
10.1136/jramc-2014-000386subject
Has Abstractpub_date
2016-02-01 00:00:00pages
30-4issue
1eissn
0035-8665issn
2052-0468pii
jramc-2014-000386journal_volume
162pub_type
杂志文章abstract：INTRODUCTION:2-Chloroacetophenone (CN), o-chlorobenzylidene malonitrile (CS) and oleoresin capsicum (OC) are common riot control agents. While serious systemic effects are uncommon, exposure to high concentrations may lead to severe complications and even death. The aim of this narrative review is to summarise all main...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章,评审
doi：10.1136/jramc-2013-000165
更新日期：2015-06-01 00:00:00
abstract：INTRODUCTION:Definitive laparotomy (DL), with completion of all surgical tasks at first laparotomy has traditionally been the basis of surgical care of severe abdominal trauma. Damage control surgery (DCS) with a goal of physiological normalisation achieved with termination of operation before completion of anatomical ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-157-04-04
更新日期：2011-12-01 00:00:00
abstract：:For military forces, the control of infectious acute gastroenteritis constitutes an old, constant and unsolved concern. Recent epidemiological studies suggest that the common bacterial causes are being overtaken by viruses. Norviruses are the most alarming group and norovirus outbreaks in military forces are regularly...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-156-04-10
更新日期：2010-12-01 00:00:00
abstract：:Post-traumatic stress disorder (PTSD) is a disabling trauma and stress-related disorder that may occur after a person experiences a traumatic event, and evokes a combination of intrusion and avoidance symptoms, negative alterations in cognitions and mood, and alterations in arousal and reactivity. Accelerated resoluti...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章,评审
doi：10.1136/jramc-2015-000417
更新日期：2016-04-01 00:00:00
abstract：:Scoring systems for both trauma and intensive care patients have been widely used since the 1960's. This article will introduce several scoring systems currently in use and discuss their potential use for military ICU patients. ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章,评审
doi：10.1136/jramc-155-02-10
更新日期：2009-06-01 00:00:00
abstract：:A survey of the orthopaedic casualties evacuated (casevacs) to the Royal Hospital Haslar between November 1995 and April 1996 was performed. A total of 464 service persons and civilians were casevaced. Orthopaedic cases amounted to 55% of all evacuations. Of these, 54% were British Army personnel. Conditions necessita...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-143-02-03
更新日期：1997-06-01 00:00:00
abstract：:The 2014-2015 Ebola virus disease (EVD) epidemic in West Africa was the largest in history. The three most affected countries, Guinea, Liberia and Sierra Leone, have faced enormous challenges in controlling transmission and providing clinical care for patients with EVD. The Chinese government, in response to the reque...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-2015-000562
更新日期：2016-06-01 00:00:00
abstract：:This article argues that there is a duty of care held by the State to military veterans who have been technologically enhanced as part of their military service. It suggests that enhancements may be permanent, persistent or protracted and demonstrates how enhancements generate additional moral responsibilities from th...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-2018-001140
更新日期：2019-08-01 00:00:00
abstract：:Both flexible and rigid cysto-urethroscopy are routinely used in the surveillance of transitional cell bladder tumours. This study addressed the issue of patient selection for either rigid or flexible cystoscopy. What proportion of positive findings at flexible cystoscopy and negative findings at rigid cystoscopy are ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-145-03-08
更新日期：1999-10-01 00:00:00
abstract：AIM:Currently, there is no research available on the experiences of spouses providing informal care to wounded, injured or sick (WIS) UK military personnel. The aim of this study was to fill this gap by investigating the relationship experiences of non-military partners caring for WIS UK military personnel. METHODS:Sp...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-2016-000679
更新日期：2017-08-01 00:00:00
abstract：:It has been stated that the application of a pre-hospital tourniquet could prevent 7% of combat deaths, however their widespread use has been questioned due to the potential risk from prolonged ischaemia. We reviewed members of the UK Armed Forces who sustained severe limb-threatening injuries in Iraq and Afghanistan,...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-155-03-06
更新日期：2009-09-01 00:00:00
abstract：:A case of pentazocine induced hallucinations which responded to treatment with Naloxone is reported. ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-130-01-10
更新日期：1984-02-01 00:00:00
abstract：:The UK military commitment to United Nations operations has led to a new challenge in identifying and developing skill sets required for humanitarian operations. The last two decades have concentrated on kinetic operations, with haemorrhage control being the main driver. The austere location and prolonged evacuation t...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-2018-001142
更新日期：2019-02-20 00:00:00
abstract：INTRODUCTION:Haemorrhage from the injured extremity is a significant cause of preventable death in military settings. This study evaluated the effect of training on the efficacy of the combat application tourniquet (CAT) and to define standards for military personnel. METHOD:Participants from a training tank battalion...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章,随机对照试验
doi：10.1136/jramc-2014-000339
更新日期：2015-12-01 00:00:00
abstract：OBJECTIVE:To examine the risk of cervical cancer in a large national cohort of military veteran women followed up for up to 30 years. METHODS:Retrospective cohort study of 5235 veteran women born between 1945 and 1985, and 20 703 women with no record of service matched for age and area of residence, using Cox proporti...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-2015-000544
更新日期：2016-10-01 00:00:00
abstract：:This article introduces a practical triage tool designed to assist commanders, jungle training instructors (JTIs) and medical personnel to identify Defence Personnel (DP) with suspected exertional heat illness (EHI). The challenges of managing suspected EHI in a jungle training environment and the potential advantages...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 社论
doi：10.1136/jramc-2017-000801
更新日期：2018-08-01 00:00:00
abstract：:Using a major ethics crisis as a methodological approach to study secret science environments, part II examines the origins and organisation of the Applied Biology Committee (ABC), the first independent research ethics committee (REC) at Porton Down, Britain's biological and chemical warfare establishment since the Fi...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 历史文章,杂志文章
doi：10.1136/jramc-2019-001207
更新日期：2019-08-01 00:00:00
abstract：:OBJECTIVES: The purpose of this study was to investigate smoking prevalence of Tri-Service recruits, and changes in smoking behaviour at 3-year follow-up, by trade group and gender. Associations with educational attainment and deprivation were also assessed. METHODS: Analysis of a survey into the health behaviours of ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-2013-000009
更新日期：2013-03-01 00:00:00
abstract：:Prehospital use of blood products may improve survival. However, transfusion support with frozen blood components is logistically burdensome and constrains the configuration of prehospital medical support. Alternatives to frozen plasma, including lyophilised plasma, offer the potential for advanced resuscitation in th...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章,评审
doi：10.1136/jramc-2014-000361
更新日期：2016-02-01 00:00:00
abstract：OBJECTIVES:To outline the characteristics and outcomes of eye injuries in the Chinese People's Liberation Army. METHODS:A retrospective review of military inpatient eye injuries, in one military region, population 250,000 soldiers, between January 2006 and December 2010. RESULTS:There were 709 eye injury patients (75...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章,多中心研究
doi：10.1136/jramc-158-04-09
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:In a care under fire situation, a first line response to haemorrhage is to apply a tourniquet and return fire. However, there is little understanding of how tourniquets and other haemorrhage control devices impact marksmanship. METHODS:We compared the impact of the iTClamp and the Combat Application Tourniq...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章,随机对照试验
doi：10.1136/jramc-2016-000664
更新日期：2017-06-01 00:00:00
abstract：INTRODUCTION:Infectious diseases are a frequent cause of morbidity among British troops. The aim of this paper is to describe the spectrum of infectious diseases seen when UK service personnel are evacuated for definitive care to the Role 4 Medical Treatment Facility based at Birmingham Heartlands Hospital. METHOD:A r...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-2017-000815
更新日期：2018-05-01 00:00:00
abstract：:Terrorism is not a new concept but our need to prepare for the effects of bioterrorism has achieved a particular urgency. The use of biological agents provides a new set of challenges to professional caregivers, emergency personnel and Governments. These agents are generally not readily identified through the senses, ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章,评审
doi：10.1136/jramc-149-02-05
更新日期：2003-06-01 00:00:00
abstract：:Proper clinical practice in the military for IUD insertion is outlined. Bimanual examination of the pelvis is prerequisite; a Cusco speculum should be used to visualize the cervix and vagina. Cervical erosion and vaginal discharges should be treated before insertion. The basic insertion method is to fix the blades ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：
更新日期：1980-10-01 00:00:00
abstract：:The vast majority of casualties will only require a common sense approach to their preparation for evacuation, by asking simple questions, most problems can be identified and resolved prior to the evacuation. Ask? Are aeromed teams available to undertake this task? (Contact them). If aeromed teams are unavailable but ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-150-01-07
更新日期：2004-03-01 00:00:00
abstract：:Belize, hosting one of the British Army's overseas training areas, provides access to challenging terrain and austere environments, which allows the delivery of training to soldiers on survival and combat within the jungle environment. A 26-year-old infanteer on exercise in Belize presented with progressive bilateral ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-2017-000811
更新日期：2017-12-01 00:00:00
abstract：:This study investigates mortality from ischaemic heart disease during 1973-1984 in males under 55 years of age in the three Armed Services. Comparisons are drawn within and between each service and with ischaemic heart disease (IHD) mortality in the UK male population. Evidence of a significant decline in the Army dea...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-133-02-14
更新日期：1987-06-01 00:00:00
abstract：:By virtue of the Battalion I serve with, I was the first Task Force Doctor on to the Falklands. On Friday the 21st May, 2 Para made an assault beach landing, thankfully unopposed, on San Carlos beach, the RAP was with them. ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 历史文章,杂志文章
doi：10.1136/jramc-153-03s-08
更新日期：2007-01-01 00:00:00
abstract：:Throughout the history of war, there have been many instances when the cold has ravaged armies more effectively than their enemies. Delineated risk factors are restricted to negro origins, previous cod injury, moderate but not heavy cigarette smoking and the possession of blood group O. No attention has been directed ...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 历史文章,杂志文章
doi：10.1136/jramc-130-02-05
更新日期：1984-06-01 00:00:00
abstract：OBJECTIVES:To investigate whether there was a difference in social characteristics in different garrison towns of the British Forces Germany and to ascertain whether the health visitor workload was different in these towns. DESIGN:Self completed questionnaires administered to mothers by health visitors on first contac...
journal_title：Journal of the Royal Army Medical Corps
pub_type： 杂志文章
doi：10.1136/jramc-144-02-07
更新日期：1998-06-01 00:00:00
