SPECIFIC ISSUES

SPECIFIC ISSUES

There is no injury that is peculiar to disasters and the whole spectrum of external injuries from minor cuts and compound fractures to amputations is seen. Internal organ damage is frequent and, unless immediate help is available, this accounts for the majority of early mortality figures. People trapped under fallen buildings may su ff er crush injuries and crush syndrome Plaster of Paris is a white crystalline powder, calcium sulphate hemihydrate CaSO - - Summary box 33.6 Principles of debridement and initial wound care /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF if the duration is prolonged. Crush injuries and missile injuries cause extensive tissue damage and gross contamination, both favourable conditions for anaerobic and microaerophilic infections.

(b) Figure 33.12 (a, b) Use of low-pressure vacuum therapy in preparing a wound for secondary closure. Obtain generous exposure through skin and fascia Identify neurovascular bundles Excise devitalised tissue Remove foreign bodies Repair major vessels Obtain skeletal stabilisation with external /f_i xators Only tag tendons and nerves that have been cut Leave the wound open and delay primary closure Avoid tight dressings Elevate the injured limb

SPECIFIC ISSUES

There is no injury that is peculiar to disasters and the whole spectrum of external injuries from minor cuts and compound fractures to amputations is seen. Internal organ damage is frequent and, unless immediate help is available, this accounts for the majority of early mortality figures. People trapped under fallen buildings may su ff er crush injuries and crush syndrome Plaster of Paris is a white crystalline powder, calcium sulphate hemihydrate CaSO - - Summary box 33.6 Principles of debridement and initial wound care /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF if the duration is prolonged. Crush injuries and missile injuries cause extensive tissue damage and gross contamination, both favourable conditions for anaerobic and microaerophilic infections.

(b) Figure 33.12 (a, b) Use of low-pressure vacuum therapy in preparing a wound for secondary closure. Obtain generous exposure through skin and fascia Identify neurovascular bundles Excise devitalised tissue Remove foreign bodies Repair major vessels Obtain skeletal stabilisation with external /f_i xators Only tag tendons and nerves that have been cut Leave the wound open and delay primary closure Avoid tight dressings Elevate the injured limb

SPECIFIC ISSUES

There is no injury that is peculiar to disasters and the whole spectrum of external injuries from minor cuts and compound fractures to amputations is seen. Internal organ damage is frequent and, unless immediate help is available, this accounts for the majority of early mortality figures. People trapped under fallen buildings may su ff er crush injuries and crush syndrome Plaster of Paris is a white crystalline powder, calcium sulphate hemihydrate CaSO - - Summary box 33.6 Principles of debridement and initial wound care /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF if the duration is prolonged. Crush injuries and missile injuries cause extensive tissue damage and gross contamination, both favourable conditions for anaerobic and microaerophilic infections.

(b) Figure 33.12 (a, b) Use of low-pressure vacuum therapy in preparing a wound for secondary closure. Obtain generous exposure through skin and fascia Identify neurovascular bundles Excise devitalised tissue Remove foreign bodies Repair major vessels Obtain skeletal stabilisation with external /f_i xators Only tag tendons and nerves that have been cut Leave the wound open and delay primary closure Avoid tight dressings Elevate the injured limb