Lundy Jonathan B, Driscoll Ian R
U.S. Army Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX 78234.
Mil Med. 2014 Mar;179(3):e347-50. doi: 10.7205/MILMED-D-13-00493.
Catastrophic pelviperineal injuries have become more commonplace on the modern battlefield as a result of dismounted blast mechanism and the survival benefits afforded by far-forward resuscitation and surgery. Inherent in the survival of casualties with such devastating injuries is both the risk for invasive infections and the need for complex reconstruction. We report a series of two combat casualties sustaining the constellation of catastrophic pelviperineal blast injury, anal sphincter complex destruction, complicated by invasive fungal infection managed with completion proctectomy. Our experience, although lacking numbers to qualify as high-level evidence to guide care, will assist future surgeons' care for similar patients.
由于下车时的爆炸机制以及前沿复苏和手术所带来的生存益处，灾难性骨盆会阴损伤在现代战场上变得更加常见。这类毁灭性损伤的伤员生存过程中存在侵袭性感染风险和复杂重建需求。我们报告了两例战斗伤员，他们遭受了灾难性骨盆会阴爆炸伤、肛门括约肌复合体破坏，并伴有侵袭性真菌感染，通过直肠切除术完成治疗。我们的经验虽因数量不足不能作为指导治疗的高级证据，但将有助于未来外科医生对类似患者的治疗。
