Breeze, John, Bowley, Douglas M, Combes, James G, Baden, James, Rickard, Rory F, DuBose, Joseph and Powers, David B (2019) Facial injury management undertaken at US and UK medical treatment facilities during the Iraq and Afghanistan conflicts: a retrospective cohort study. BMJ open, 9 (11). e033557. ISSN 2044-6055. This article is available to all UHB staff and students login using a UHB Athens Account. Register for Athens here - https://openathens.nice.org.uk/
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Abstract
OBJECTIVES
To perform the first direct comparison of the facial injuries sustained and treatment performed at USA and UK deployed medical treatment facilities (MTFs) in support of the military campaigns in Iraq and Afghanistan.
SETTING
The US and UK Joint Theatre Trauma Registries were scrutinised for all patients with facial injuries presenting alive to a UK or US deployed MTF between 1 March 2003 and 31 October 2011.
PARTICIPANTS
US and UK military personnel, local police, local military and civilians.
PRIMARY AND SECONDARY OUTCOME MEASURES
An adjusted multiple logistic regression model was performed using tracheostomy as the primary dependent outcome variable and treatment in a US MTF, US or UK military, mandible fracture and treatment of mandible fracture as independent secondary variables.
RESULTS
Facial injuries were identified in 16 944 casualties, with the most common being those to skin/muscle (64%), bone fractures (36%), inner/middle ear (28%) and intraoral damage (11%). Facial injuries were equally likely to undergo surgery in US MTF as UK MTF (OR: 1.06, 95% CI 0.4603 to 1.142, p=0.6656); however, variations were seen in injury type treated. In US MTF, 692/1452 (48%) of mandible fractures were treated by either open or closed reduction compared with 0/167 (0%) in UK MTF (χ: 113.6; p≤0.0001). US military casualties who had treatment of their mandible fracture (open reduction and internal fixation or mandibulo-maxillary fixation) were less likely to have had a tracheostomy than those who did not undergo stabilisation of the fractured mandible (OR: 0.61, 95% CI 0.44 to 0.86; p=0.0066).
CONCLUSIONS
The capability to surgically treat mandible fractures by open or closed reduction should be considered as an integral component of deployed coalition surgical care in the future.
Item Type: | Article |
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Additional Information: | This article is available to all UHB staff and students login using a UHB Athens Account. Register for Athens here - https://openathens.nice.org.uk/ |
Subjects: | WU Dentistry. Oral surgery |
Divisions: | Planned IP Care > General Surgery |
Related URLs: | |
Depositing User: | Mrs Yolande Brookes |
Date Deposited: | 29 Nov 2019 15:10 |
Last Modified: | 05 May 2022 07:25 |
URI: | http://www.repository.uhblibrary.co.uk/id/eprint/2647 |
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