COMBAT THORACIC SURGERY IN RECENT CONFLICTS: 2002-2016.
Zsolt Stockinger, MD, Caryn Turner, MPH, Jennifer Gurney, MD. Joint Trauma SystemObjectives: Thoracic surgery constitutes 2.5% of surgical procedures performed in theater, but these are increasingly foreign to military surgeons. This study examines thoracic surgical workload in Iraq and Afghanistan to help define surgical training gaps. Methods: Retrospective analysis of Department of Defense Trauma Registry… Continue Reading
Medical Management of Severe Traumatic Brain Injury in Afghanistan at Forward Deployed Surgical Units Demonstrates a Potential Knowledge or Utilization Gap in Patient Management
G Baluh, MD, E Mann-Salinas, PhD, A Staudt, PhD, J Gurney, MD, S Shackelford, MD, J Nielsen, MD, T Becker, MD. SAMMCObjectives: Military surgeons deployed to locations with limited resources, i.e. Role 2 medical treatment facilities (MTF), are often required to care for patients sustaining severe traumatic brain injuries (sTBI). It is paramount in sTBI… Continue Reading
Outcomes following administration of tranexamic acid in military traumatic brain injury
Patrick F Walker, MD, Joseph D Bozzay, MD, Luke R Johnston, MD, Eric A Elster, MD, Carlos J Rodriguez, DO, Matthew J Bradley, MD. Department of Surgery, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MarylandOBJECTIVES: Tranexamic acid (TXA) may be a useful adjunct for military patients with… Continue Reading
Prolonged Field Care – The U.S. Air Force Pararescue Experience
Erik DeSoucy, DO1, Seth Zweben, NREMTP2, Stacy Shackelford, MD3, Joseph J DuBose, MD1, Russ S Kotwal, MD, MPH3, Harold R Montgomery, SOATP3, Sean Keenan, MD4, Stephen C Rush, MD2. 1David Grant Medical Center, 2U.S. Air Force Pararescue, 3Joint Trauma System, 4Special Operations Command, EuropeIntroduction: United States Air Force Pararescue is an elite special operations force… Continue Reading
Improving Fasciotomy Performance: A Focused Needs Assessment for Military Surgeon Simulation Training
Walter B Kucera, MD, Matthew D Nealeigh, DO, Brenton Franklin, MD, Mark Bowyer, MD, W. Brian Sweeney, MD, E. Matthew Ritter, MD. Uniformed Services University / Walter Reed National Military Medical CenterObjectives: Many injuries from the wars in Iraq and Afghanistan involve extremity trauma secondary to blasts. The wounding patterns from these blasts predispose patients to… Continue Reading
Delayed Presentations of Trauma Encountered during Large-Scale US Navy Humanitarian Aid Missions
Jason B Brill, LCDR, MC, USN, James D Wallace, LCDR, MC, USN, Romeo C Ignacio, CAPT, MC, USN. Naval Medical Center San DiegoObjectives: A 1000-bed floating hospital, USNS Mercy (T-AH 19) has provided large-scale humanitarian aid (HA) throughout Southeast Asia. As the focus of these missions, designated Pacific Partnership (PP), is to provide low risk,… Continue Reading
Mobile Forward Looking Infrared Technology Allows Rapid Assessment of Resuscitative Endovascular Balloon Occlusion of the Aorta in Hemorrhage and Blackout Conditions
Morgan R Barron, MD, John Kuckelman, DO, John McClellan, MD, Michael Derickson, MD, Cody Phillips, DO, Shannon Marko, DVM, Kyle Sokol, MD, Rowan Sheldon, MDMatthew Eckert, MD, Matthew Martin, MD. Madigan Army Medical CenterIntroduction: Objective assessment of final REBOA position and adequate distal occlusion is clinically limited, particularly in patients with hemorrhagic shock. We propose… Continue Reading
TOO FAST, OR NOT FAST ENOUGH? THE FAST EXAM IN PATIENTS WITH NON-COMPRESSIBLE TORSO HEMORRHAGE
Woo S Do, MD1, Matthew J Eckert, MD1, Ronald Chang, MD2, Erin E Fox, PhD2, Charles E Wade, PhD2, John B Holcomb2, Matthew J Martin1. 1Legacy Emmanuel Medical Center, Portland, OR, 2Center for Translational Injury Research, University of Texas Health Science Center, Houston, TXObjectives: Trauma surgeons assessing patients with non-compressible torso hemorrhage (NCTH) often rely… Continue Reading
Saline Hydro-Flotation is Superior to Bioresorable Membranes in Decreasing Intra-Abdominal Adhesion Formation in a Rat Model
John Kuckelman, Morgan Barron, Kevin Kniery, Jeffrey Kay, Joseph Kononchik, Zachary Hoffer, Vance Sohn. Madigan Army Medical CenterINTRODUCTION: Adhesion formation after laparotomy remains a major cause of post-operative morbidity. Hyaluronate/carboxymethylcellulose membranes (HAC) are costly bioresorbable membranes that represent current anti-adhesion therapy. Alternatively, hydro-flotation using saline theoretically provides a transient barrier during adhesion formation. We sought… Continue Reading
EXTENDING THE GOLDEN HOUR FOR ZONE 1 REBOA: IMPROVED SURVIVAL AND REPERFUSION INJURY WITH INTERMITTENT VERSUS CONTINUOUS REBOA IN A PORCINE SEVERE TRUNCAL HEMORRHAGE MODEL
John Kuckelman, Morgan Barron, Donald Moe, Michael Derickson, Cody Phillips, Joseph Kononchik, Michael Lallemand, Shannon Marko, Matthew Eckert, Matthew Martin. Madigan Army Medical CenterINTRODUCTION: Non-compressible truncal hemorrhage can be temporarily controlled using resuscitative endovascular occlusion of the aorta (REBOA). Prolonged ischemia has limited REBOA application, but intermittent inflation schedules may be a strategy to mitigate… Continue Reading
Vasopressin Administration During Fluid Resuscitation Alters Expression of Epigenetic Enzymes of Renal Artery in a Pig Model of Hemorrhagic Shock
Jillian M Piaggione, MD1, Lee-Ann M Murata, MSc2, Catherine F Uyehara, PhD2, Dao H Ho, PhD2. 1Department of General Surgery, Tripler Army Medical Center, 2Department of Clinical Investigation, Tripler Army Medical CenterObjectives. Trauma accounts for ~50% of combat-related deaths. Rapid blood loss from trauma can lead to hemorrhagic shock resulting in organ damage. Renal function… Continue Reading
Final Report of a Randomized Phase 1b Trial to Assess Sequencing of the E39 and E39′ Vaccines to Optimize Long-term Antitumor Immunity in Folate Binding Protein (FBP)-Expressing Breast and Ovarian Tumors
John W Myers, MD1, Kaitlin M Peace, MD1, Timothy J Vreeland, MD2, Diane F Hale, MD1, Doreen O Jackson, MD1, Julia M Greene, MD1, Tommy A Brown, MD1, Guy T Clifton, MD1, George E Peoples, MD3, Elizabeth A Mittendorf, MD, PhD2. 1Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX, 2The University of… Continue Reading
AN EVALUATION OF NOVEL MEDICAL DEVICES AND OTHER INTERVENTIONS IN THE TREATMENT OF TENSION PNEUMOTHORAX IN A SWINE MODEL
Rowan R Sheldon, MD, Michael J Derickson, MD, Woo S Do, MD, Dominic M Forte, MD, Jessica B Weiss, MD, Matthew J Eckert, Matthew J Martin, MD. Madigan Army Medical Center, Tacoma, WAObjectives: Tension pneumothorax (tPTX) is the second most common cause of preventable death in trauma. Needle decompression is the first-line intervention but has… Continue Reading
A Novel Bioresorbable/Biointegratable/Biocompatible Dressing for Negative Pressure Wound Therapy
Samuel Tahk, MD, PhD1, Renford Cindass, MD1, Kevin Wu, MD2, Nicholas Robbins, DO3, Jian Ling, PhD4, Bijaya Parida, PhD2, Vijay Gorantla, MD, PhD5, Erik Weitzel, MD2, Michael Davis, MD2. 1San Antonio Military Medical Center, 259th Medical Wing United States Air Force, 3University of Texas Health Sciences Center, 4Southwest Research Institute at San Antonio, 5University of… Continue Reading
Plasma Co-Administration Improves Resuscitation with Tranexamic Acid or Prothrombin Complex in a Porcine Hemorrhagic Shock Model
John P Kuckelman, Morgan Barron, MD, Donald Moe, Michael Lallemand, John McClellan, Shannon Marko, Matthew Eckert, Matthew Martin. Madigan Army Medical CenterOBJECTIVE: Traumatic coagulopathy has now been well characterized, but still carries high rates of mortality due to bleeding. A "factor-based" resuscitation strategy using pro-coagulant drugs and factor concentrates in lieu of plasma is being… Continue Reading