Blyth Dana M, Yun Heather C, Tribble David R, Murray Clinton K
From the Infectious Disease Service (D.M.B., H.C.Y., C.K.M.), San Antonio Military Medical Center, JBSA Fort Sam Houston, San Antonio, Texas; and Infectious Disease Clinical Research Program (D.R.T.), Uniformed Services University of the Health Sciences, Bethesda, Maryland.
J Trauma Acute Care Surg. 2015 Oct;79(4 Suppl 2):S227-35. doi: 10.1097/TA.0000000000000768.
In over a decade of war, numerous advancements have been made to improve overall combat-related mortality, but infectious complications remain a leading cause of both morbidity and mortality in combat-related injured personnel. Here we will attempt to compare the challenges and lessons of combat-related injuries and infections from the Vietnam War with those of OIF/OEF. Throughout the Vietnam War and OIF/OEF, there have been similar infection-related challenges faced in caring for combat-related trauma patients. Both conflicts reinforced the importance of rapid medical evacuation and definitive surgical management of war wounds. They revealed the constant evolution of infecting organisms and the challenge of increasing antimicrobial resistance. We have also seen that with decreased mortality of severely injured personnel new morbidities must be addressed. Using the foundation of fragmented research from the Vietnam War, previously successful models were assembled into joint service research institutions which have allowed these questions to be addressed. However, many questions regarding measures to reduce infectious complications in our combat-injured personnel remain unanswered. Continued research building on established knowledge is critical for continued improvements in the care of combat-related trauma patients.
在十多年的战争中，为降低与战斗相关的总体死亡率已取得了诸多进展，但感染性并发症仍是战斗负伤人员发病和死亡的主要原因。在此，我们将尝试比较越南战争与伊拉克自由行动/持久自由行动中与战斗相关的损伤及感染所面临的挑战与教训。在整个越南战争以及伊拉克自由行动/持久自由行动期间，在救治与战斗相关的创伤患者时面临着类似的与感染相关的挑战。这两场冲突都凸显了快速医疗后送以及对战伤进行确定性手术治疗的重要性。它们揭示了感染病原体的不断演变以及日益增加的抗菌药物耐药性所带来的挑战。我们还看到，随着重伤员死亡率的降低，必须应对新出现的发病情况。基于越南战争中零散的研究成果，以往成功的模式被整合到联合勤务研究机构中，从而能够解决这些问题。然而，关于降低我们战斗负伤人员感染性并发症的措施，仍有许多问题未得到解答。在既有知识基础上持续开展研究对于不断改善与战斗相关创伤患者的治疗至关重要。
