Multiple blast extremity injuries: is definitive treatment achievable in a field hospital for local casualties?

Abstract

The objective of this report was to analyse injury patterns and definitive management of local casualties with multiple blast extremity injuries in the Kabul International Airport Combat Support Hospital. A clinical prospective study was performed from July 2012 to January 2013. Afghan victims of a blast trauma with a minimum of two extremities injured and an Injury Severity Score (ISS) greater than 8 were included. Two groups were considered for analysis: group A including patients with amputations and group LS including patients with limb salvage procedures. During this period 19 patients were included with a total of 57 extremity injuries. There were six patients in group A and 13 patients in group LS, with a mean number of injuries of 3.5 and 2.8, respectively. The ISS, blood products utilization and overall time of surgery were significantly greater in group A. Reconstruction of multiple blast extremity injuries may be achieved in a field hospital despite limited resources and operational constraints. However, this activity requires the utilization of significant supplies and major investment from the caregivers deployed.