The Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, WACC 435, Boston, MA 02114, USA.
The Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; Medical Corps, U.S. Navy Active Reserve Component, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, WACC 435, Boston, MA 02114, USA.
Clin Plast Surg. 2021 Apr;48(2):349-361. doi: 10.1016/j.cps.2021.01.005.
Evolution in extremity injury treatment often occurs during major conflicts, with lessons learned applied and translated among military and civilian settings. In recent periods of war, improvements in protective equipment, in-theater damage control resuscitation/surgery, delivery of antibiotics locally/systemically, and rapid evacuation to higher levels of medical care capabilities have greatly improved combat casualty survivability rates. Additionally, widespread application of lower extremity tourniquets also has prevented casualties from exsanguination, thus reducing hemorrhagic-related deaths. Secondary to these, a high number of combat casualties suffering lower extremity traumatic injuries have presented for functional limb reconstruction and restoration as well as residual limb care.
在重大冲突期间，四肢创伤治疗的进展通常会发生，军事和民用环境之间会相互借鉴和转化经验教训。在最近的几次战争中，防护装备的改进、现场损伤控制复苏/手术、局部/全身给予抗生素以及快速转移到更高水平的医疗能力，都极大地提高了战斗伤员的存活率。此外，广泛应用下肢止血带也防止了伤员失血过多，从而减少了与出血相关的死亡。在此基础上，大量四肢创伤伤员需要进行功能性肢体重建和恢复以及残肢护理。
