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Abbreviated closure for remote damage control laparotomy in extreme environments: a randomized trial of sutures versus wound clamps comparing terrestrial and weightless conditions

Par Conseil national de recherches du Canada

DOITrouver le DOI : https://doi.org/10.1016/j.amjsurg.2017.03.027
AuteurRechercher : ; Rechercher : ; Rechercher : ; Rechercher : ; Rechercher : ; Rechercher : 1; Rechercher : ; Rechercher : ; Rechercher :
Affiliation du nom
  1. Conseil national de recherches du Canada. Aérospatiale
FormatTexte, Article
Sujetexsanguination; operational medicine; tactical medicine; damage control surgery; surgical simulation
Résumé
Introduction: Far-Forward Damage Control Laparotomies (DCLs) might provide direct-compression of visceral hemorrhage, however, suturing is a limiting factor, especially for non-physicians. We thus compared abbreviated skin closures comparing skin-suture (SS) versus wound-clamp (WC), on-board a research aircraft in weightlessness (0g) and normal gravity (1g). Methods: Surgeons conducted DCLs on a surgical-simulator; onboard the hangered-aircraft (1g), or during parabolic flight (0g), randomized to either WC or SS. Results: Ten surgeons participated. Two (40%) surgeons randomized to suture in 0g were incapacitated with motion-sickness, and none were able to close in either 1 or 0g. With WC, two completely closed in 1g as did three in 0g, despite having longer incisions (p = 0.016). Overall skin-closure with WC was significantly greater in both 1g (p = 0.016) and 0g (p = 0.008). Conclusions: WC was more effective in 1g and particularly 0g. Future studies should address the utility of abbreviated WC abdominal closure to facilitate potential Far-Forward DCL.
Date de publication
Maison d’éditionElsevier
Dans
  • The American Journal of Surgery 213, nº 5 : 862–869.
Langueanglais
Publications évaluées par des pairsOui
Numéro NPARC23002587
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Identificateur de l’enregistremente15e85fa-4a50-4f70-8664-5dc3762f5540
Enregistrement créé2017-12-04
Enregistrement modifié2020-03-16
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