War Wounds (Not high yield)

Question 1

What is the definition of wound infection?

Answer 1

One of the following:
Organisms cultured from tissue or drainage
Purulent drainage
Abscess or other evidence of infection
Two of: localized pain, redness, swelling, heat

Question 2

What is the microbiological epidemiology of war wounds?

Answer 2

High energy blasts cause massive tissue energy and disseminate foreign bodies into tissue, prolonged exposure increases chance of nosocomial infection

Question 3

What are other factors affecting war wounds?

Answer 3

Immunized warfighters (low tetanus)
Body armor (introduces fibers to body)
Helicopters decrease time to treatment
Transfusion capacity
Increased Abx Delivery
Dismounted vs. Mounted patrol

Question 4

What are important things to know about Acinetobacter

Answer 4

Multi-drug resistant
Gram negative rod predominating in Iraq war
Requires triple drug therapy

Question 5

What are common Abx for empiric treatment of War Wounds?

Answer 5

Meropenem, Vancomycin, Antifungals
BUT!
If it doesn’t look infected than don’t treat it