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• W1964367090 abstract "Sir: We read in a recent Journal article that American combatants who sustained traumatic wounds during Operation Iraqi Freedom had a 1 percent infection rate with the use of vacuum-assisted closure.1 The article referenced a Massachusetts General Hospital Web site that quoted Col. Donald Jenkins, Air Force trauma surgeon, as stating, “few medical devices have saved more lives in Iraq than the wound vacuum, which has cut rates of infection among wounded U.S. combatants to a mere 1 percent.”2 At our military institutions in the United States, we are not seeing that remarkably low infection rate among our American military casualties who have sustained traumatic injuries while deployed to Iraq. Col. Jenkins indicates that the data reflect Iraqi casualties, not American. Traditionally, American casualties are rapidly evacuated out of combat theaters without the application of vacuum-assisted closure, though recently the vacuum-assisted device has been authorized by the Air Force for in-flight evacuation care. Col. Jenkins has a recently accepted publication that reports a 0 percent infection rate among 77 Iraqi casualties treated with vacuum-assisted closure.3 There are limited data about infection rates among American combatants injured in Iraq and Afghanistan. Lin et al. reported on 52 casualties with orthopedic injuries evacuated to Walter Reed Army Medical Center from the war in Afghanistan.4 Only two patients had infections, both with amputations, and one of them was treated with the vacuum-assisted device. Although the total number of patients treated with vacuum-assisted closure was not specified, eight procedures coded as vacuum-assisted closure were reported. Preliminary data from Brooke Army Medical Center described 26 of 66 orthopedic injuries among American casualties admitted between January and June of 2006 receiving antibiotics for suspected soft-tissue infections and/or osteomyelitis.5 While it is unknown which of those patients were treated with vacuum-assisted closure, it is very common at our institution to use this device in patients with complex wounds. Although data are not available at this time to characterize the infection rate among U.S. military personnel who are treated with vacuum-assisted closure, it does appear that among local nationals treated with this device in Iraq the infection rate is less than the 1 percent reported by Argenta et al.1 The U.S. military is actively collecting and interpreting data from this current conflict to improve our treatment of wounded soldiers and civilians. Current areas of research include identification of pathogens and resistance patterns, tracking of culture results in theater and through the evacuation system, and preparation of a database that includes factors that may be associated with infection rates. Ongoing initiatives to collect data for outcomes research, such as the Joint Theater Trauma Registry and the Military Extremity Trauma and Amputation/Limb Salvage (METALS), have been implemented. We hope to have these data to report in the future. Steven J. Lalliss, M.D. Joanna G. Branstetter, M.D. Clinton K. Murray, M.D. James R. Ficke, M.D. Donald H. Jenkins, M.D. United States Army Institute of Surgical Research Fort Sam Houston San Antonio, Texas" @default.
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• W1964367090 date "2007-08-01" @default.
• W1964367090 modified "2023-09-26" @default.
• W1964367090 title "Infection Rates in U.S. Military Personnel Using Vacuum-Assisted Closure" @default.
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• W1964367090 doi "https://doi.org/10.1097/01.prs.0000267671.78598.b4" @default.
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