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Dismounted Complex Blast Injuries

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Surgery During Natural Disasters, Combat, Terrorist Attacks, and Crisis Situations

Abstract

Dismounted complex blast injuries (DCBIs) are no longer limited to the battlefield. A blast inflicts blunt, penetrating, and thermal trauma, creating a complex injury pattern. The pattern of injuries in DCBI is characterized by amputation of at least 1 lower extremity, severe injuries to one or more other extremities, and a constellation of pelvic, abdominal, and urogenital wounding. The key element of success in treating these patients is a systematic approach beginning at the point of detonation. The earliest and most crucial treatment priority is hemorrhage control. This is best accomplished in the prehospital setting with a tourniquet. Damage control resuscitation with blood and products should begin en route or immediately upon arrival at the hospital. The initial surgical priorities are based on damage control principles and focus on surgical hemorrhage control and aggressive debridement of debris and devitalized tissue. While the most dramatic injuries are related to the amputations, one must consider other injuries such as ocular, mild traumatic brain injury, tympanic membrane rupture, and maxillary facial injuries. Infection control is essential for long term survival.

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Authors and Affiliations

  1. Division of Trauma, Acute Care Surgery and Surgical Critical Care, Department of Surgery, Davis Medical Center, University of California, 2315 Stockton Blvd., North Wing, Rm. 4206, Sacramento, CA, 95817, USA

    Joseph M. Galante M.D.

  2. Department of General Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA

    Carlos J. Rodriguez D.O., M.B.A.

Authors
  1. Joseph M. Galante M.D.
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  2. Carlos J. Rodriguez D.O., M.B.A.
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Correspondence to Joseph M. Galante M.D. .

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Editors and Affiliations

  1. Department of Surgery, Advanced Laparoscopy and Metabolic Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA

    COL Robert B. Lim

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© 2016 Springer International Publishing Switzerland

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Galante, J.M., Rodriguez, C.J. (2016). Dismounted Complex Blast Injuries. In: Lim, C. (eds) Surgery During Natural Disasters, Combat, Terrorist Attacks, and Crisis Situations. Springer, Cham. https://doi.org/10.1007/978-3-319-23718-3_15

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  • DOI: https://doi.org/10.1007/978-3-319-23718-3_15

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23717-6

  • Online ISBN: 978-3-319-23718-3

  • eBook Packages: MedicineMedicine (R0)

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