Czymek R, Lenz S, Düsel W
Chirurgische Abteilung, Bundeswehrkrankenhaus, Berlin.
Chirurg. 1999 Oct;70(10):1156-62. doi: 10.1007/s001040050879.
Medical treatment of injured patients by international missions of non-governmental organisations in crisis areas and out-of-area operations by troops, and also national disasters require special trauma management. Deviations from peacetime surgical guidelines are obligatory because of long-distance medical evacuation, the possibility of gaps in supply and the typical pattern of war injuries. Massive contamination combined with the high risk of infection is one typical attribute of wounds inflicted during a war or a disaster. In contrast to peacetime surgical guidelines, aggressive wound débridement is often needed. Timely and prophylactically prescription of a broad-spectrum antibiotic with a long half-life has great importance in the treatment of these wounds. Suitable antibiotics for these indications are: piperacillin/tazobactam and ceftriazon. Nevertheless the use of antimicrobial agents will only be effective with early surgical débridement.
非政府组织在危机地区开展的国际救援任务、部队的境外行动以及国内灾害中对受伤患者的医疗救治，都需要特殊的创伤管理。由于长途医疗后送、物资供应可能出现缺口以及战争伤的典型模式，有必要偏离和平时期的外科指南。大量污染加上高感染风险是战争或灾难中伤口的一个典型特征。与和平时期的外科指南不同，往往需要积极的伤口清创术。及时预防性地开具半衰期长的广谱抗生素对这些伤口的治疗非常重要。适用于这些指征的抗生素有：哌拉西林/他唑巴坦和头孢曲松。然而，只有早期进行外科清创术，使用抗菌药物才会有效。
