title: Dismounted Complex Blast Injuries Including Invasive Fungal Infections.
abstract: Large blast injuries during dismounted operations in southwest Afghanistan causing major limb amputations and perineal injuries associated with large blood volume resuscitation were associated with invasive fungal, primarily mold, infections. This article outlines the interventions undertaken to mitigate excess morbidity and mortality associated with invasive fungal infection. These interventions include defining the problem and associated risk with systemically collected and analyzed information, developing improved protective body armor for the thigh and perineal region, standardizing management through clinical practice guidelines that outlined risk, diagnostic and treatment recommendations with enhanced discussions on the weekly Theater Combat Casualty Care Conference that includes personnel from the combat zone, Germany, and the United States. The article concludes by explaining the key way forward with regarding an inner-war approach to sustained knowledge and skills.
authors.affiliation: US Army Medical Department Center and School, JBSA Fort Sam Houston, Texas.
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
authors.forename: Kirby
authors.initials: K
authors.lastname: Gross
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Russell
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Haslett
mesh_terms: D055826:Afghan Campaign 2001-; D001753:Blast Injuries / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D006801:Humans; D000072742:Invasive Fungal Infections / Q000453:epidemiology* / Q000401:mortality; D008887:Military Medicine / Q000379:methods / Q000706:statistics & numerical data; D008889:Military Personnel / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D014481:United States / Q000453:epidemiology