Wound Debridement Research Articles

Vascularized Omentum Lymphatic Transplantation as a Treatment for Chronic Inguinal Ulceration and Lymphedema.

After tumor resection, lymphadenectomy, and radiotherapy, recurrent lymphatic fluid leakage and infection can occur in the inguinal region, contributing to severe localized tissue fibrosis. When wounds form in this region, they tend to heal slowly over extended periods, and no optimal approach for treating these complex wounds has yet been established. Groin wound debridement and dissection of the vessels in the wound recipient site were performed by the burn surgeon. A general surgeon performed the laparoscopic partial omentum excision. One portion of the omentum was used to fill the large inguinal space, whereas the other portion was laid flat on the wound sites in the groin and anterior perineum to facilitate the restoration of appropriate lymphatic fluid reflux. The vessels of the omentum were microsurgically anastomosed with the vessels in the recipient site. Thin split-thickness slices of skin were then taken from this donor site based on the size of the wound. After the successful establishment of revascularization between the flap and recipient sites, lymphatic fluid leakage was not observed in this patient. No inguinal wounding or lymphatic exudate were evident in the patient during follow-up, and significant improvements in lymphedema of the lower extremities were evident. In this article, we discuss the advantages and disadvantages of vascularized omentum lymphatic transplantation. Overall, this procedure represents a promising new approach for the treatment of refractory wounds caused by lymphatic fistulas.

PREVENTION AND TREATMENT OF POSTOPERATIVE INFECTIONS IN IMPACTED THIRD MOLAR SURGERIES

repair are examined, highlighting the importance of the blood clot and its adverse effects, from its malformation to its loss. The study covers risk factors, diagnosis, symptoms and prevention of these complications, emphasizing that infections can manifest up to 30 days after surgery. Although uncommon, these infections are seen as the main reason for delayed healing after surgery. The classification of third molar removal surgery as contamination is debated in relation to the incidence of infections, highlighting the importance of care and operative technique compared to the prophylactic administration of antibiotics. Specific guidelines are demonstrated for patients with compromised immune systems. The content develops prevention strategies, including decontamination, use of sterile materials, drug therapy, cleaning and debridement of surgical wounds in order to treat and prevent such infections. It stresses that the use of antibiotics is not justified by the absence of biosafety precautions and emphasizes the essentiality of maintaining the aseptic chain for successful treatment. This research aims to contribute to a more in-depth understanding of post-operative complications in third molar extractions, providing a preventative and effective approach to dental surgery.

Identification of a gene promoter active in Lucilia sericata larval salivary glands using a rapid transient expression assay

Tissue-specific gene promoters are desired as they provide the specificity needed for control of gene expression in transgenic animals. Here we describe a relatively rapid two-component transient expression assay that was used to identify a gene promoter active in the larval salivary glands of the green blow fly, Lucilia sericata. Sterile L.sericata maggots are widely used for wound debridement. A larval salivary gland gene promoter could be used to make maggots that secrete factors for enhanced wound therapy. Embryos from a line that carry a tetracycline transactivator (tTA)-activated red fluorescent protein gene were injected with plasmid DNA with the tTA gene driven by a constitutive or tissue-specific gene promoter. The hatched larvae were reared on diet and then examined for red fluorescence. A promoter from the LsCG30371 gene was active in the larval salivary glands. The tissue-specificity of the promoter was subsequently confirmed with stable transgenic lines that carried the LsCG30371-tTA gene. The relatively rapid transient expression assay could potentially be used to determine the tissue-specificity of other gene promoters. Further, the stable LsCG30371-tTA lines could be used to make sterile maggots that secrete factors from the salivary glands for enhanced wound healing.

The development of international wound debridement best practice recommendations: Consensus between nurses specialized in Wound, Ostomy and Continence Canada and the society of tissue viability

Debridement is an important component of wound management and can improve outcomes for patients. Debridement needs to be done by an appropriately trained health professional, but the scope of practice, credentials, training, competencies, and regulatory requirements regarding wound debridement can differ. Best Practice Recommendations were created to positively influence patient safety related to all methods of debridement, across the continuum of care, and to be implemented widely by nurses at all professional levels in Canada. AimTo further develop the Best Practice Recommendations for wound debridement, with an international perspective, by creating a consensus document to support the global adoption of evidence-based debridement practice for health professionals. MethodsA consensus meeting utilising Delphi methods was conducted between the authors to review the consensus statements. Once 80 % agreement was achieved, a wide range of wound care experts were identified by the authors and invited to participate in an external review of the statements. ResultsFifteen consensus statements about wound debridement were agreed upon and are presented in this paper. ConclusionsThese best practice recommendations have been reviewed by a wide range of practitioners from across the UK and Canada and aim to provide guidance on the standardisation of debridement practices for healthcare professionals.

The role of upper airway ultrasonography in tracheal necrosis diagnosis: a case report

BackgroundTracheal necrosis post endotracheal intubation is a rare life-threatening disease that can compromise airway patency. We demonstrated a novel usage of upper airway ultrasonography (USG) to diagnose tracheal necrosis.Case presentationA middle-aged smoking male presented with productive cough, noisy breathing and exertional dyspnea for 2 weeks. He was intubated one month prior due to a traumatic brain injury. Upper airway USG findings showed irregular air-mucosal interface (AMI) and comet tail artefacts over the 1st and 2nd tracheal ring. A direct laryngoscopy in the operating room showed thick mucopus inferior to the vocal cords, with necrotic tracheal cartilages and debris obstructing the airway. He was successfully treated with parenteral antibiotics, wound debridement and tracheostomy.ConclusionOur case highlights the first documented USG findings of tracheal necrosis. Upper airway USG serves as a potential diagnostic modality in managing the condition.

Dual Mobility Cup in Total Hip Arthroplasty

Abstract Background Proximal femoral fractures are considered a common problem in the elderly. Osteoporosis and the risk of fall especially in old age add to the complexity of management of these types of fractures. These fractures can be managed with different types of implants e.g. Dynamic hip screw, proximal femoral nail, proximal femoral plate, etc.. Aim of the Work Prospective clinical trial study to assess the role of dual mobility unconstrained acetabular components in preventing and treating instability. Patients and Methods In the period between December 2014 to April 2017 a prospective study was conducted involving 25 patients with high risk of dislocation underwent total hip replacement using dual mobility cup either as primary hip arthroplasty or revision hip arthroplasty. All cases were operated upon in Ain Shams University Hospitals and the follow up of the cases was 1 year. Results There were no cases of prosthesis dislocation or loosening. There were only two cases of superficial wound infections who improved with wound debridement. Studies showed that the dual mobility cup did a great success in reduction in the risk of dislocation in specific conditions as patients with polio and other neuromuscular disorders and other risk factors for head dislocation. Conclusion Conversion of a failed implant to a total hip implant is a good and safe option in treatment of such cases. Dual mobility cups decreased the risk of dislocation in such cases with increased longevity of the prosthesis and a considerably accepted range of motion of the hip joint.

Investigation of metal non-opaque foreign bodies of firearm origin by radiation methods

Background. The purpose is to investigate metal non-opaque foreign bodies of firearm origin. Materials and methods. Five cases of removing soft tissue foreign bodies of gunshot origin were investigated, when radiography of the limb soft tissues didn’t detect foreign bodies, but they were removed during the primary surgical wound debridement. X-ray of soft tissue gunshot wounds found no foreign bodies. To study radiographic density, foreign bodies were placed in a foam model with subsequent multislice computed tomography. For spectral analysis of metal foreign bodies, we used wavelengths unconventional for X-ray, which allowed to conduct X-ray fluorescence and X-ray structural studies. Results. Radiographic density of metal foreign bodies ranged from 989 to 2123 HU. Given the different thickness of foreign bodies, from 0.4 to 3.2 mm, the average was 1700 ± 189 HU. The foam had radiographic density of –969 HU with model dimensions of 200 × 100 × 50 mm. When examining samples of foreign bodies, it was found that they are deformed, have different thicknesses. One of the samples is light and smooth on one side, and dark and rough on the other. X-ray fluorescence results: composition on the light side (% by mass): Al — base, Mn — 0.8, Fe — 0.3, Zn — 0.1, Cr — 0.05, Ti — 0.2, corresponding to Al-Mn alloy. The dark side is an oxidized Al-Mn alloy. In the spectrum of the dark side of the sample, the Br-Kα line was detected, which indicates the participation of bromine compounds in the oxidation process. From the smooth side of the sample, the spectrum of this line is not determined. Conclusions. Non-opaque metal foreign bodies of gunshot origin are a rare phenomenon. Metal foreign bodies with low radiographic density are non-ferromagnetic, the use of modern magnetic surgical instruments will not be effective. Visualization of metal foreign bodies, which are not determined by radiography, is possible with the help of multislice computed tomography. The use of the wavelength of primary radiation, which is unconventional for X-ray spectral analysis, and original X-ray optical schemes allows for quantitative determination of the composition and structure of any metal foreign bodies.

Extensive Fournier’s Gangrene Due to Delayed Management of Perianal Abscess in Uncontrolled Diabetes: A Case Report

Abstract Fournier’s gangrene is a rapidly spreading gangrene predominantly affecting the genital and perianal region. It has the highest mortality and is more common in immunocompromised and diabetic patients. Poorly controlled diabetes is one of the common risk factors for Fournier’s gangrene. Delayed diagnosis and treatment increase mortality by nearly 100%. In our case, the patient was initially managed for a perianal abscess and later progressed to Fournier’s gangrene. A 48-year-old male diabetic presented with erythematous swelling in the right-side scrotal region for one-week duration. He had a recent perianal abscess and underwent incision and drainage at another hospital He also reported fever with chills and rigors for the past two days. The patient is now in a state of septic shock. He has a history of irregular medication for type 2 diabetes mellitus. Clinical examination confirmed Fournier’s gangrene resulting from a perianal abscess in the context of uncontrolled diabetes. The patient underwent an emergency wound debridement under spinal anesthesia. Extensive wound debridement was performed on the right hemiscrotum. Necrotic tissue was debrided on the right perianal region. The patient was initiated on empirical antibiotics, receiving a calculated dose of cefoperazone with sulbactam and metronidazole. Additionally, the patient underwent sitz baths and received regular wound dressing. Following wound debridement and glycemic control with insulin, the patient showed signs of improvement. Four weeks post-debridement, the patient underwent split-skin grafting for the raw area on the scrotum, while the fistula site was allowed to heal by secondary intention. The cornerstone in managing perianal abscess with Fournier’s gangrene in diabetic patients is extensive wound debridement, antibiotic coverage, and proper management of diabetes. Early diagnosis and prompt surgery of perianal abscess can reduce the risk of developing Fournier’s gangrene in diabetic patients. Post-surgical raw areas can be effectively managed with split-skin grafts.

Repairing Exposed Tendon Wounds with Absorbable Gelatin Sponges and Autologous Split-Thickness Skin Grafts: A Case Series.

Conventional flap repair surgery has several drawbacks, including operational complexity, donor site damage, and high risk. In this case series, the authors explored an alternative approach for repairing exposed tendon wounds caused by trauma using absorbable gelatin sponges (AGSs) and autologous thigh skin grafts. This report presents two cases of lower-extremity skin necrosis with tendon exposure following wound debridement. The treatment approach involved early debridement, negative-pressure wound therapy, and wound irrigation with 0.9% sodium chloride. Upon achieving controlled wound infection, AGSs were applied to the exposed tendon to prevent degeneration and promote wound healing. Subsequently, areas where granulation tissue failed to cover the tendon were repaired using AGSs and 0.25-mm-thick autologous mesh skin grafts harvested from the thigh. Complete wound healing was achieved in both cases, on the 20th and 12th day after skin grafting, respectively. The proposed method proved successful in repairing exposed tendon wounds, effectively preventing infection and necrosis.

Clinical Perspectives on Post-Operative Care for Tethered Oral Tissues (TOTs)

Introduction: Post-operative frenectomy care is often focused on active wound management (AWM) and followed by neuromuscular re-education (NMR). The standard practices of AWM are varied amongst providers. AWM is often expected to be performed by caregivers who have little to no experience with AWM. In contrast, NMR is individualized to patient needs and has been emerging in external evidence as a beneficial modality for the functional implications of tethered oral tissues (TOTs). It is guided by licensed professionals but is not often accessible or recommended. New Perspective: AWM and NMR often are similar in execution but differ in goals. AWM is focused on wound debridement and avoiding scarring or reattachment of the frena, whereas NMR is focused on airway, sleep, feeding, swallowing, speech, and optimal orofacial growth. AWM has little consensus or external evidence compared to NMR which has both internal and external evidence. AWM for oral care is also limited by scope of practice (SOP) which few licensed professionals have. NMR has a broader range of professionals such as International Board-Certified Lactation Consultants (IBCLCs), speech-language pathologists (SLPs), physical and occupational therapists (PT/OT) and registered dental hygienists (RDHs). Conclusions: NMR has multiple benefits post-operatively, is individualized and performed by multiple professionals. It is suggested that release providers consider gentle, functionally directed post-operative NMR techniques that are individualized, and research the impact these approaches have on wound care goals.

Advancing Fingertip Regeneration: Outcomes from a New Conservative Treatment Protocol.

Background Fingertip injuries with volar pulp tissue defects present a significant challenge in management. This study aimed to evaluate the efficacy of a conservative treatment protocol using artificial dermis and semi-occlusive dressings for these injuries. Methods A single-center, prospective study was conducted on 31 patients with fingertip injuries involving volar pulp defects. The treatment protocol included wound debridement, application of artificial dermis (Pelnac®), and a semi-occlusive dressing (IV3000®). The outcomes were assessed using subjective questionnaires and objective measures, including fingerprint regeneration, sensory function, pain, and cosmetic appearance. Results The mean treatment duration was 45.29 days (SD = 17.53). Complications were minimal, with only one case (3.22%) directly attributable to the treatment. Fingerprint regeneration was considerable (mean score = 2.58, SD = 0.67). The sensory disturbances were minimal, with no significant differences across injury types. Post-treatment pain was low (mean = 0.45, SD = 0.67), and cosmetic satisfaction was high (mean = 4.09, SD = 0.94). The overall patient satisfaction was high (mean = 4.41, SD = 0.67), regardless of injury severity. Conclusions The conservative treatment protocol using artificial dermis and semi-occlusive dressings is a promising strategy for managing fingertip injuries with volar pulp defects. This approach minimizes surgical morbidity and achieves excellent functional and aesthetic outcomes.

A Study on the Involvement of Facial Bones in Mucormycosis Patients.

To study the involvement of various facial bones in mucormycosis patients. 50 Mucormycosis patients were included in the study after getting their consent from a tertiary care center in Chennai. 50 mucormycosis patients were included from a tertiary care centre in Tamilnadu.The details regarding their symptoms-onset, duration and progression, associated comorbidities were noted.The involvement of various facial bones were assessed by CT paranasal sinuses/CT facial bones and MRI brain with orbit with contrast. Among the study population, the nasal cavity and maxillary sinuses were affected first. In patients who are presenting late, this infection spreads to the base of skull through blood vessels and presents as rhino-orbito-cerebral form.Patients presenting late had high chances of bony erosion.Maxillary osteomyelitis and necrosis has been observed commonly.22 patients had facial bone involvement in this study and they needed thorough wound debridement with removal of the necrosed bone. Mucormycosis is often accompanied by a poor prognosis and a high mortality rate. Hence, aggressive surgical intervention with antifungal therapy is usually necessary. Early diagnosis and prompt treatment can reduce the mortality and morbidity of this lethal fungal infection.

Trauma surgical relevance of bite injuries by animals and humans

Bite injuries require differentiated treatment due to the deeply inoculated polymicrobial pathogen spectrum, possible concomitant injuries and pronounced soft tissue damage. Dog bites are the most common bite injuries but are less complicated to heal than human and cat bites. The location of the bite greatly depends on the age and the size of the bite victim as well as the type of bite perpetrator. In every case detection of the pathogen should be carried out to provide the best possible adapted treatment in the event of an exacerbation. The primary antibiotic treatment should be empirical with amoxicillin + clavulanic acid or ampicillin + sulbactam and, if necessary, adjusted according to the antibiogram. Depending on the findings, surgical treatment includes excision of the bite canal and acustomized wound debridement. It is important to check the vaccination status of those involved and if indicated, to carry out postexposure prophylaxis for tetanus and rabies.

A multifunctional thermosensitive hydrogel based on phototherapy for promoting the healing of dental extraction wounds.

Post-extraction wound infections are a common complication of dental extractions. More specifically, infection in the alveolar socket after tooth extraction accelerates the resorption and destruction of the alveolar bone, and ultimately affects the final restoration results. Currently, the main clinical treatment approaches applied to the socket after tooth extraction include mechanical wound debridement, chemical rinses (e.g., chlorhexidine), filling of the extraction socket with absorbent gelatin sponges, and the systemic application of antibiotics. However, these traditional treatment modalities have some limitations and their therapeutic effects are unsatisfactory. In this study, a phototherapeutic temperature-sensitive hydrogel material was constructed for injection using a tea polyphenol (TP)-modified poly-N-isopropylacrylamide (PNIPAM) hydrogel skeleton loaded with the photosensitiser indocyanine green (ICG). The resulting PNIPAM-TP/ICG system exhibited an excellent injectability and temperature-sensitive properties. In addition, it stopped haemorrhaging and acted as a wound astringent. The hydrogel steadily released ICG into the oral environment to exert photothermal/photodynamic effects along with synergistic antibacterial and anti-inflammatory properties when combined with tea polyphenols. In vivo experiments demonstrated that the application of PNIPAM-TP/ICG to infected dental extraction wounds in rats rapidly stopped the bleeding and accelerated wound healing. Overall, this study describes a drug-loaded, temperature-sensitive hydrogel for the treatment of open wound infections, and shows promise as a reference for the treatment of tooth extraction wounds.

Effectiveness of a Glyceryl Trinitrate (GTN) Patch in Preventing Amputation, Improving Pain Control and Reducing the Size of Tissue Loss for a Patient With Critical Limb-Threatening Ischaemia (CLTI).

Background Foot ulcer is a common complication of poorly controlled diabetes and peripheral vascular disease (PVD). The current standard of treatment for diabetic foot ulcers includes the management of underlying risk factors, wound debridement, use of antibiotics for infection, off-loading with cast, and revascularisation surgery. The glyceryl trinitrate (GTN) patch is currently off-licence in treating PVD or diabetic foot ulcers. This study aims to evaluate the effectiveness of the GTN patch in preventing amputation, improving pain control, and reducing the size of tissue loss (ulcer/gangrene) or localised ischaemic area. Method This is a pilot study of 30 patients who were started on the GTN patchfrom February 2020 to October 2021. Inclusion criteria were patients who have critical limb-threatening ischaemia (CLTI) and with no viable options or are at high risk for revascularisation, both endovascular and open surgery. Patients who were on a GTN patch for less than six weeks at the time of data collection or had unclear outcomes were excluded. The outcomes were retrospectively collected on prevention of amputation, improvement in pain control, and reduction in tissue loss (the size of ulcer/gangrene) or localised ischaemic area with the use of a GTN patch. The binomial test was used to compare the observed outcome of the GTN patch and the expected outcome, which was assumed to be 50% in this study. Results Ninety-three per cent (93%) of the patients who had GTN patches successfully avoided amputation (p<0.0001). Eighty-four per cent (84%) of patients reported better pain control (p=0.0022) and improvement in the size of ulcer/gangrene/localised ischaemic areas (p=0.0005). Conclusion The GTN patch is effective in preventing amputation, improving pain control, and reducing the size of ulcer/gangrene/localised ischaemic areas in patients who have end-stage CLTI and no viable options or who are at high risk for revascularisation surgery.

Partial Gluteus Muscle Flap for Treatment of Chronic, Recalcitrant Pilonidal Cyst Disease.

Pilonidal cyst disease is a challenging condition requiring excision and wound management when it is chronic and symptomatic. Primary closure of the excision site can lead to high recurrence rates, necessitating flap-based reconstruction. This article discusses the use of a partial gluteus maximus muscle flap to address recurrent pilonidal disease and reduce its recurrence. From 2014 to 2021, 11 patients aged 14-31 with recurrent pilonidal cysts underwent two-stage surgery involving excision and wound debridement by general surgery, followed by plastic surgery for wound closure using the partial gluteus muscle flap. Eleven patients were included in the study (four women and seven men). The mean age was 23 ± 5.2, and the average body mass index was 28.59 (±6.7). The mean number of previous procedures was 2.25 (range, 2-3). Operative time was 158.7 ± 37 minutes. The average length of stay when both procedures were done in the same admission was 8 ± 6 days (range 3-21 days) and when procedures were done separately, the length of hospital stay after the wound closure using a partial gluteus muscle flap was 3 days, and the range for reliable follow-up was 1.6-7 years postoperatively. In our study cohort of 11 patients, the majority, specifically seven individuals, experienced uneventful healing. However, a subset of patients encountered complications. Three patients developed an infection recurrence: one was treated conservatively, and one required reoperation with resolution of symptoms, and one patient also experienced wound dehiscence, which was closed with a small procedure. Partial gluteal muscle flap offers a promising approach for treating recalcitrant, difficult-to-treat pilonidal disease in young adults, enhancing wound healing and reducing the risk of recurrence.

Comparison of Efficacy of Topical Carica papaya Leaf Extract and Hemocoagulase in Postoperative Wound Healing After Therapeutic Orthodontic Premolar Extractions: a Split Mouth Study.

Introduction Postoperative wound healing is the most important factor in the outcome of any surgical procedure. Wound healing is a dynamic process involving inflammation, neovascularization, granulation, fibroblast proliferation, re-epithelization, and remodeling. It repairs tissue integrity, restoring the body's natural defense barrier. A hastened wound healing will help in the quicker re-establishment of the body's homeostasis. Carica papaya includes vital nutrients and bioactive substances such as minerals, vitamins, and antioxidants. Its primary active ingredientpapaincauses the enzymatic debridement of wounds. Hemocoagulase is a thrombin-like serine protease that is mostly employed for its procoagulant and wound-healing characteristics. It is derived from the venom of Bothrops species of snakes. This study aims to compare the wound-healing properties of topical Carica papaya leaf extract and Hemocoagulase after dental extractions. Materials & Methods For 48 patients requiring bilateral therapeutic dental extraction for orthodontic intervention, Carica papaya leaf extract (Caripill 275mg/5ml) was topically applied to the extraction socket on one side, and Hemocoagulase 0.2 CU solution (Botroclot) was applied to the extraction socket on the other side. The bilateral premolars were extracted for orthodontic treatment under local anesthesia. Patients were asked to apply the solution topically twice daily for seven days and were called forreview on the seventh day. The assessment of the efficacy of both solutions in post-operative wound healing was the objective of the study. Healing was assessed by using a blinded single observer for all patients using Landry's healing index. Results A total of 48 subjects with 96 sites completed the study, with a mean age of 15.4 years. The study population consisted of 24 males and 24 females, which were evenly distributed among the two study groups. On comparison of wound healing index (WHI) scores between the two groups using the Wilcoxon signed rank test, Group A had a significantly higher mean rank than Group B with regards to the wound healing indexscore, and the results were statistically significant (p = 0.037). Conclusion It can be concluded from the study that Carica papaya leaf extract showed better wound healing in post-extraction sockets compared to Hemocoagulase. This study presents the promising useof natural extracts such as Carica papaya in wound healing because they are easily accessible to patients, more economical, and haveno adverse reactions. More studies that focus on natural extracts to promote wound healing are required in the future.

Best practice for wound debridement.

Best practice for wound debridement.

A CASE SERIES AND LITERATURE REVIEW: MANAGEMENT STRATEGIES FOR RADIATION-INDUCED ULCERS OF THE CHEST

Highlights: Radiotherapy leads to a high occurrence of skin alterations and can advance to different levels of tissue damage, presenting challenges in treatment. Management can be effective employing diverse wound treatment methods, although severe cases may necessitate surgical intervention. Surgery takes into several key considerations to increase chances of success and tackle specific issues of chest wall instability and breast reconstruction. Abstract: Introduction: Radiotherapy as an adjunct to cancer treatment causes a high incidence of radiation-induced tissue injury, ranging from radiation dermatitis to severe osteoradionecrosis. Currently, no gold standard exists in the management of radiation injury. Various strategies ranging from modern wound treatment to surgical management have been studied. Case Illustration: Three women presented with varying degrees of ulceration in the chest during or shortly following radiotherapy. Each case followed different approaches to management. One case solely received wound treatment, another received wound treatment and a sequestrectomy, and the third required surgical reconstruction of the chest wall and defect. Discussion: Methods of wound treatment range from topical agents, barrier films and dressings, hydrogel and hydrocolloid dressings, miscellaneous treatments, and biodressings. Surgery is required in severe cases, particularly with osteoradionecrosis. This may include wound debridement, biopsy, chest wall stabilization, closure using various flaps, and potential breast reconstruction. Conclusion: Radiation-induced ulcers of the chest pose a complex issue. Understanding effective treatment methods and key surgical principles is important for ensuring better outcomes. Further studies are needed to provide a complete guide to treatment.

Characteristics of injuries during the 2006 Lebanon conflict: a three-center retrospective study of survivors, 16 years after the conflict.

Armed conflict injury is a growing public health concern, particularly in regions like the Middle East and North Africa (MENA). The protracted conflicts and political unrest in this region have led to a substantial number of injuries. Despite this, there is still limited understanding of the specific injury patterns stemming from conflicts, such as the 2006 Lebanon conflict. This study aimed to assess the characteristics and burdens of injuries resulting from this conflict, which occurred 16 years prior to this research. This retrospective study analyzed data of individuals affected by the 2006 Lebanon conflict, across three tertiary care centers. Demographics, injuries, complications, injury management, and hospitalization expenses were extracted from medical records and analyzed using SPSS version 29.0. Categorical variables were presented as counts and proportions, and continuous variables as mean ± standard deviation (SD). Hospital comparisons utilized chi-square or Fisher's exact tests for categorical variables, and one-way ANOVAs for continuous variables. Analysis was conducted from September to November 2023. Across three hospitals, 341 patients were studied, comprising 73.6% males and 26.4% females. Among them, a notable proportion (57.3% males and 34.1% females) fell within the 18-39 age range. Children and adolescents under 18 years accounted for 15.9% of males and 25.9% of females. Blast-related injuries predominated, with 24.5% resulting from direct damage caused by explosive parts and 33.3% from blast wave forces. Extremity trauma occurred in 49.0% of patients, and head/neck trauma in 24.9%. Common injuries, including penetrating, musculoskeletal, and traumatic brain injuries affected 34.9%, 31.1, and 10.0% of patients, respectively. Wound repair, fracture treatment, and debridement were the most performed procedures on 15.5, 13.5 and 9.7% of the patients, respectively. The total cost of care was USD 692,711, largely covered by the Ministry of Public Health (95.9%). Conflict-related injuries significantly contribute to the global burden of disease. Therefore, there is a pressing need to improve national guidelines to prioritize life-threatening cases and potential long-term disabilities. Furthermore, enhancing electronic registry systems to collect clinical data on injured patients is essential for conducting research and better understanding the needs of conflict casualties.