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Disaster-Related Injury Management: High Prevalence of Wound Infection After Super Typhoon Haiyan

  • Yong Won Kim (a1), Seong Yeop Kim (a2), Hoon Kim (a3), Moo Eob Ahn (a4), Kang Hyun Lee (a1) and Eun Seok Hong (a5)...

Abstract

Background

After Super Typhoon Haiyan, a category 5 tropical cyclone, insufficient resources were available for medical management. Many patients in the Philippines were wounded as a result of the disaster. We examined the prevalence, risk factors, and consequences of disaster-related wounds and wound infection in the post-disaster period.

Methods

We performed a retrospective review of consecutive patients admitted to a Korean Disaster Relief Team clinic at St. Paul’s Hospital, Tacloban City, Republic of Philippines, between December 9 and 13, 2013. Traumatic injury patients were included; patients not exhibiting a wound were excluded.

Results

Of the 160 patients enrolled in the study, 71 (44.4%) had infected wounds. There were no significant differences in the age, sex, past medical history, wound site, wound depth, injury mechanism, or inducer of injury between the uninfected and infected groups. In the univariate analysis, a foreign-body-contaminated wound, a chronic wound, elapsed time from injury to medical contact, an inadequately cared for wound, and need for subsequent wound management were associated with wound infection (P<0.05). The multivariate analysis revealed that foreign body contamination and having an inadequately cared for wound were associated with wound infection (odds ratio [OR]: 10.12, 95% confidence interval [CI]: 3.59-28.56; OR: 3.51, 95% CI: 1.07-11.51, respectively).

Conclusion

In the post-disaster situation, many wound infections required definitive care. Wound infection was associated with inadequately cared for wounds and foreign-body-contaminated wounds. (Disaster Med Public Health Preparedness. 2016;10:28–33)

Copyright

Corresponding author

Correspondence and reprint requests to Eun Seok Hong, MD, Department of Emergency Medicine, College of Medicine, Ulsan University, 877 Jeonha-dong, Dong-gu, Ulsan 682-714, Republic of Korea (e-mail: ulsaner@gmail.com).

References

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1. SitRep No. 73 Effects of Typhoon “Yolanda” (Haiyan). Situational reports re effects of Typhoon Yolanda (Haiyan). National Disaster Risk Reduction and Management Council website. http://www.ndrrmc.gov.ph/index.php/21-disaster-events/1329-situational-report-re-effects-of-typhoon-yolanda-haiyan. Published December 18, 2013. Accessed August 11, 2015.
2. Fischetti, M. Was Typhoon Haiyan a record storm? Scientific American. http://blogs.scientificamerican.com/observations/was-typhoon-haiyan-a-record-storm/. Published November 12, 2013. Accessed August 11, 2015.
3. Millie, M, Senkowski, C, Stuart, L, et al. Tornado disaster in rural Georgia: triage response, injury patterns, lessons learned. Am Surg. 2000;66:223-228.
4. Uscher-Pines, L, Vernick, JS, Curriero, F, Lieberman, R, Burke, TA. Disaster-related injuries in the period of recovery: the effect of prolonged displacement on risk of injury in older adults. J Trauma. 2009;67(4):834-840. http://dx.doi.org/10.1097/TA.0b013e31817f2853.
5. Xu, Y, Huang, J, Zhou, J, Zeng, Y. Patterns of abdominal injury in 37 387 disaster patients from the Wenchuan earthquake. Emerg Med J. 2013;30(7):538-542. http://dx.doi.org/10.1136/emermed-2012-201300.
6. Phalkey, R, Reinhardt, JD, Marx, M. Injury epidemiology after the 2001 Gujarat earthquake in India: a retrospective analysis of injuries treated at a rural hospital in the Kutch district immediately after the disaster. Glob Health Action. 2011;4(00):7196. http://dx.doi.org/10.3402/gha.v4i0.7196.
7. Whyte, AG. Letter: disaster wound treatment. BMJ. 1975;4(5987):43-44. http://dx.doi.org/10.1136/bmj.4.5987.43-b.
8. Robson, MC. Wound infection. A failure of wound healing caused by an imbalance of bacteria. Surg Clin North Am. 1997;77(3):637-650. http://dx.doi.org/10.1016/S0039-6109(05)70572-7.
9. Norris, SO, Provo, B, Stotts, NA. Physiology of wound healing and risk factors that impede the healing process. AACN Clin Issues Crit Care Nurs. 1990;1:545-552.
10. Dryden, SV, Shoemaker, WG, Kim, JH. Wound management and nutrition for optimal wound healing. Atlas Oral Maxillofac Surg Clin North Am. 2013;21(1):37-47. http://dx.doi.org/10.1016/j.cxom.2012.12.008.
11. Brem, H, Jacobs, T, Vileikyte, L, et al. Wound-healing protocols for diabetic foot and pressure ulcers. Surg Technol Int. 2003;11:85-92.
12. Perencevich, EN, Sands, KE, Cosgrove, SE, Guadagnoli, E, Meara, E, Platt, R. Health and economic impact of surgical site infections diagnosed after hospital discharge. Emerg Infect Dis. 2003;9(2):196-203. http://dx.doi.org/10.3201/eid0902.020232.
13. Whitehouse, JD, Friedman, ND, Kirkland, KB, et al. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol. 2002;23:183-189.
14. Kirkland, KB, Briggs, JP, Trivette, SL, et al. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999;20:725-730.
15. Poulsen, KB, Bremmelgaard, A, Sorensen, AI, Raahave, D, Petersen, JV. Estimated costs of postoperative wound infections. A case-control study of marginal hospital and social security costs. Epidemiol Infect. 1994;113(02):283-295. http://dx.doi.org/10.1017/S0950268800051712.
16. Vegas, AA, Jodra, VM, Garcia, ML. Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization. Eur J Epidemiol. 1993;9:504-510.
17. Ennis, WJ. Disaster management, triage-based wound care, and patient safety: reflections on practice following an earthquake. Ostomy Wound Manage. 2010;56:61-69.
18. Liu, HQ, Yang, SM, Xu, H, et al. Investigation and management of wound on head and neck from the disaster area in Wenchuan earthquake. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008;43:643-646.
19. Maegele, M, Gregor, S, Yuecel, N, et al. One year ago not business as usual: wound management, infection and psychoemotional control during tertiary medical care following the 2004 Tsunami disaster in southeast Asia. Crit Care. 2006;10(2):R50. http://dx.doi.org/10.1186/cc4868.
20. Okumura, J, Kai, T, Hayati, Z, et al. Antimicrobial therapy for water-associated wound infections in a disaster setting: gram-negative bacilli in an aquatic environment and lessons from Banda Aceh. Prehosp Disaster Med. 2009;24:189-196.
21. Lim, PL. Wound infections in tsunami survivors: a commentary. Ann Acad Med Singapore. 2005;34:582-585.
22. Levy, MJ, Tang, N. Use of tissue adhesive as a field expedient barrier dressing for hand wounds in disaster responders. Prehosp Disaster Med. 2014;29(1):107-109. doi: 10.1017/S1049023X13009205.
23. Missair, A, Pretto, EA, Visan, A, et al. A matter of life or limb? A review of traumatic injury patterns and anesthesia techniques for disaster relief after major earthquakes. Anesth Analg. 2013;117(4):934-941. http://dx.doi.org/10.1213/ANE.0b013e3182a0d7a7.
24. Afshar, M, Raju, M, Ansell, D, Bleck, TP. Narrative review: tetanus-a health threat after natural disasters in developing countries. Ann Intern Med. 2011;154(5):329-335. http://dx.doi.org/10.7326/0003-4819-154-5-201103010-00007.
25. Firth, PG, Solomon, JB, Roberts, LL, et al. Airway management of tetanus after the Haitian earthquake: new aspects of old observations. Anesth Analg. 2011;113:545-547.
26. Sutiono, AB, Qiantori, A, Suwa, H, Ohta, T. Characteristic tetanus infection in disaster-affected areas: case study of the Yogyakarta earthquakes in Indonesia. BMC Res Notes. 2010;3(1):8. http://dx.doi.org/10.1186/1756-0500-3-8.

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