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首页> 外文期刊>Clinical Medicine Insights: Trauma and Intensive Medicine >The Use of a Temporary Intraluminal Shunt to Restore Lower Limb Perfusion Over a 4,000 Mile Air Evacuation in a Special Operations Military Setting: A Case Report
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The Use of a Temporary Intraluminal Shunt to Restore Lower Limb Perfusion Over a 4,000 Mile Air Evacuation in a Special Operations Military Setting: A Case Report

机译：在特殊行动军事环境中使用临时管腔内分流术在4,000英里空中撤离时恢复下肢灌注的情况：一例报告

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Limb salvage in patients who have sustained major extremity vascular trauma during wartime has increased significantly over time: World War II, 50%; Korean War, 87%; and Vietnam, 92%.1-3 This increased salvage rate is attributed to arterial reconstruction. Delay in revascularization continues to hamper limb salvage both in military settings as well as civilian trauma settings. Damage control surgery (DCS) has revolutionized modern trauma care both in the civilian arena and on the battlefield. Temporary intraluminal shunts are shown to provide adequate limb and organ perfusion in the damage control setting in the civilian trauma literature until a severely injured patient is stable enough to undergo a formal vascular repair, and/or major fractures are stabilized and devitalized soft tissue is debrided.4,5 Rural surgeons sometimes deal with a delay in evacuation due to geographic distances between accident site and level one trauma centers as well as weather delays. Such challenges can be found in each region of the country and in current military activities throughout the world. Eger and associates were the first to report the use of temporary shunts in the damage control setting at a fixed tertiary care facility.6 However, there are few retrospective reports showing their successful use in the far-forward, military7,8 field environment and none showing usefulness in a strategic evacuation. This case report of using a temporary intraluminal shunt represents one extreme aspect of damage control surgery (DCS) as applied to the austere conditions of a far-forward, military special operations environment on the modern battlefield during initial combat operations in Afghanistan.
机译：战时遭受大肢血管创伤的患者的肢体救助随着时间的推移而显着增加：第二次世界大战，50％;朝鲜战争，占87％;越南为92％。1-3挽救率的提高归因于动脉重建。血运重建的延迟继续在军事环境和平民创伤环境中阻碍肢体抢救。损伤控制手术（DCS）彻底改变了平民领域和战场上的现代创伤护理。在民用创伤文献中，临时管腔内分流术可在损伤控制环境中提供足够的肢体和器官灌注，直到严重受伤的患者稳定到足以进行正式的血管修复，和/或稳定了大的骨折并清除了失活的软组织为止.4,5由于事故现场与一级创伤中心之间的地理距离以及天气的延迟，农村外科医生有时会处理疏散的工作。这些挑战可以在该国的每个地区以及全世界目前的军事活动中找到。埃格和他的同事是第一个报告在固定的三级照料设施的损害控制环境中使用临时分流器的人。6然而，很少有回顾性报告显示它们在远距离的军事7、8野外环境中的成功使用。在战略疏散中显示有用性。该案例报告使用临时管腔内分流术代表了伤害控制手术（DCS）的一个极端方面，该方法应用于阿富汗战场上现代战场上前卫的军事特种作战环境的严峻条件。

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