title: Dismounted Complex Blast Injury.
abstract: The severe Dismounted Complex Blast Injury (DCBI) is characterized by high-energy injuries to the bilateral lower extremities (usually proximal transfemoral amputations) and/or upper extremity (usually involving the non-dominant side), in addition to open pelvic injuries, genitourinary, and abdominal trauma. Initial resuscitation and multidisciplinary surgical management appear to be the keys to survival. Definitive treatment follows general principals of open wound management and includes decontamination through aggressive and frequent debridement, hemorrhage control, viable tissue preservation, and appropriate timing of wound closure. These devastating injuries are associated with paradoxically favorable survival rates, but associated injuries and higher amputation levels lead to more difficult reconstructive challenges.
authors.affiliation: Orthopaedic Surgery Service, Walter Reed National Military Medical Center, Bethesda, MD, USA. Romney.andersen@med.navy.mil
authors.forename: Romney C
authors.initials: RC
authors.lastname: Andersen
authors.forename: Mark
authors.initials: M
authors.lastname: Fleming
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Forsberg
authors.forename: Wade T
authors.initials: WT
authors.lastname: Gordon
authors.forename: George P
authors.initials: GP
authors.lastname: Nanos
authors.forename: Michael T
authors.initials: MT
authors.lastname: Charlton
authors.forename: James R
authors.initials: JR
authors.lastname: Ficke
mesh_terms: D000673:Amputation, Traumatic / Q000628:therapy*; D001753:Blast Injuries / Q000628:therapy*; D006801:Humans; D023821:Limb Salvage; D008887:Military Medicine / Q000379:methods*; D012151:Resuscitation