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Key Points of Preliminary Treatment for Patients with Extremity Trauma Based on Analysis of Amputation Cases

Published online by Cambridge University Press:  07 October 2019

Yao Jiang Open the ORCID record for Yao Jiang [Opens in a new window] ,
Ming-Hua Liu ,
Qiang Xiang  and
Yun-Gui Wang
Yao Jiang
Affiliation:
Army Medical University (Third Military Medical University), Shapingba District, Chongqing, China
Ming-Hua Liu
Affiliation:
Department of Emergency, Southwest Hospital, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, China
Qiang Xiang*
Affiliation:
Department of Emergency, Southwest Hospital, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, China
Yun-Gui Wang*
Affiliation:
Army Medical University (Third Military Medical University), Shapingba District, Chongqing, China
*
Correspondence: Qiang Xiang Department of Emergency, Southwest Hospital Army Medical University (Third Military Medical University) No. 30 Gaotanyan Road Shapingba District Chongqing 400038, China E-mail: 429654680@qq.com Yun-Gui Wang Army Medical University No. 30 Gaotanyan Road Shapingba District Chongqing 400038, China E-mail: wygui@sina.com
Correspondence: Qiang Xiang Department of Emergency, Southwest Hospital Army Medical University (Third Military Medical University) No. 30 Gaotanyan Road Shapingba District Chongqing 400038, China E-mail: 429654680@qq.com Yun-Gui Wang Army Medical University No. 30 Gaotanyan Road Shapingba District Chongqing 400038, China E-mail: wygui@sina.com
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Abstract

Introduction:

Severe trauma can lead to amputation of limbs. There is no golden standard or comprehensive evaluation indicator for amputation. It is difficult for the primary rescue organization to focus on the most essential indicators and to determine whether to perform amputation or take proper operation.

Problem:

For medical staff in first-line medical teams for disaster relief or in a common primary hospital, what indicators should they focus on to keep the patient’s limbs when they receive wounded patients with severe trauma?

Methods:

A retrospective case-control study was performed based on the patients with severe trauma from January 2013 through December 2018 in the emergency department of Southwest Hospital (Shapingba District, Chongqing, China), a Level I trauma center. A total of 165 cases were divided into amputation group (n = 79) and non-amputation control group (n = 86), which had severe skin and muscle injury but without amputation. The causes of trauma and the special cases were analyzed. Binary logistic regression models were used to find the essential indicators for amputation.

Conclusions:

Neurovascular injury with delayed treatment was the most decisive indicator leading to amputation, and time phase was also important for limb salvage. Preliminary treatment of disaster victims and patients with severe trauma should focus on neurovascular status and timely delivery.

Keywords

disaster medicineprehospital emergency caretraumatic amputation
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 6 , December 2019 , pp. 592 - 595
Copyright
© World Association for Disaster and Emergency Medicine 2019 

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