Tajsic Nenad B, Husum Hans
Department of Orthopaedic and Trauma Surgery, University Hospital Northern Norway, Tromsoe, Norway.
J Trauma. 2008 Dec;65(6):1463-7. doi: 10.1097/TA.0b013e318173f803.
Severe wartime injuries often require microsurgical reconstruction or pedicle flap transfer. The aim of the study is to explore if such reconstructive surgery can be performed under low-resource conditions in a rural area.
A clinical intervention study was performed at rural hospital in a war scenario in the Balkans.
Thirty-four patients underwent microsurgical postinjury reconstructions for land mine or blast injuries. Five different types of flaps were used. Three patients developed postoperative complications and was reoperated (8.3%, 95% CI 1.8-22.5%).
The actual intervention demonstrates that skilled surgical teams can perform advanced reconstructive surgery in low-resource settings. The experience is not only relevant for wartime scenarios, but also in civilian trauma where decentralization of microsurgical service may be feasible.
严重的战时损伤常常需要显微外科重建或带蒂皮瓣转移。本研究的目的是探讨在农村地区资源匮乏的条件下能否进行此类重建手术。
在巴尔干地区战争背景下的一家农村医院开展了一项临床干预研究。
34例患者因地雷或爆炸伤接受了伤后显微外科重建手术。使用了五种不同类型的皮瓣。3例患者出现术后并发症并接受了再次手术（8.3%，95%可信区间1.8 - 22.5%）。
实际干预表明，技术熟练的手术团队能够在资源匮乏的环境中开展高级重建手术。这一经验不仅适用于战时情况，在民用创伤中，显微外科服务的分散化或许也是可行的。
