http://hdl.handle.net/10144/12518 Sat, 18 May 2013 13:10:49 GMT 2013-05-18T13:10:49Z http://hdl.handle.net/10144/279015 Title: Snakebite on the hand: Lessons from two clinical cases illustrating difficulties of Surgical Indication Authors: Gras, S Sun, 30 Dec 2012 00:00:00 GMT http://hdl.handle.net/10144/279015 2012-12-30T00:00:00Z http://hdl.handle.net/10144/280916 Title: Amputation in emergency situations: indications, techniques and Médecins Sans Frontières France's experience in Haiti Authors: Herard, Patrick; Boillot, François Abstract: PURPOSE: The decision to amputate is always difficult but becomes even harder in emergency situations, which usually present extra complicating factors. MSF EXPERIENCE: These include human factors (related to both the surgeon and the patient); poor or nonexistent medical facilities, especially in war conditions or resource-poor countries; and cultural and religious considerations. Médecins Sans Frontières (MSF) has developed a quick medical and logistical response that relies on surgical protocols adapted to emergency situations, together with complete "kits" of medical equipment, supplies and inflatable facilities. CONCLUSION: Our response to Haiti's 2010 earthquake relied on these tools but also highlighted the need to develop more detailed protocols that will help our teams on the ground. Tue, 15 May 2012 00:00:00 GMT http://hdl.handle.net/10144/280916 2012-05-15T00:00:00Z http://hdl.handle.net/10144/255400 Title: Reconstruction of Nonunion Tibial Fractures in War-Wounded Iraqi Civilians, 2006-2008: Better Late Than Never Authors: Fakri, Rasheed M; Al Ani, Ali M K; Rose, Angela M C; Alras, Majd S; Daumas, Laurent; Baron, Emmanuel; Khaddaj, Sinan; Hérard, Patrick Abstract: OBJECTIVE:: To describe medical care and surgical outcome after functional reconstructive surgery in late-presenting patients who already had at least one prior operation. DESIGN:: Retrospective review of medical care and surgical outcome from August 2006 to December 2008 using patient records for initial data with active follow-up for the latest outcome information. SETTING:: Médecins sans Frontières surgical programme in Jordan Red Crescent Hospital, Amman, Jordan. PATIENTS:: Sixty-two civilians with nonunion tibial fractures caused by war-related trauma in Iraq; 53 completed follow-up. INTERVENTION:: Amputation and/or reconstruction. MAIN OUTCOME MEASUREMENTS:: Late surgical complications (after the patient's return to Iraq) were analyzed for infection recurrence, bone union, and functional condition (defined using the Short Musculoskeletal Functional Assessment score). RESULTS:: Almost three fourths of patients arrived with infected injuries, nine of whom had amputation as the initial surgery; the rest, and all uninfected patients, had reconstruction. Excluding loss to follow-up, only four of 53 (8%) patients who arrived with an infected injury had infection recurrence. Excluding loss to follow-up and amputation, two of 14 (14%) patients in the uninfected and five of 30 (17%) in the infected injury group did not achieve successful tibial union. Mean Dysfunctional and Bothersome Indices overall were 27.1 and 29.8, respectively, with similar results for all three groups (amputations, uninfected, and infected injuries). CONCLUSIONS:: Our study shows that patients with infected and uninfected injuries surgically treated in Amman achieved similar outcomes. Despite late presentation, our patients had a comparable outcome to other studies dealing with early reconstruction. Reconstruction for the infected group required longer treatment time. Description: Article approval pending Tue, 10 Jan 2012 00:00:00 GMT http://hdl.handle.net/10144/255400 2012-01-10T00:00:00Z http://hdl.handle.net/10144/203618 Title: Providing surgical care in Somalia: A model of task shifting. Authors: Chu, Kathryn M; Ford, Nathan P; Trelles, Miguel Abstract: ABSTRACT: Fri, 01 Jul 2011 00:00:00 GMT http://hdl.handle.net/10144/203618 2011-07-01T00:00:00Z