Guidelines for the prevention of infections associated with combat-related injuries: 2011 update endorsed by the infectious diseases society of America and the surgical infection society

Duane R. Hospenthal*, Clinton K. Murray, Romney C. Andersen, R. Bryan Bell, Jason H. Calhoun, Leopoldo C. Cancio, John M. Cho, Kevin K. Chung, Jon C. Clasper, Marcus H. Colyer, Nicholas G. Conger, George P. Costanzo, Helen K. Crouch, Thomas K. Curry, Laurie C.D. Avignon, Warren C. Dorlac, James R. Dunne, Brian J. Eastridge, James R. Ficke, Mark E. FlemingMichael A. Forgione, Andrew D. Green, Robert G. Hale, David K. Hayes, John B. Holcomb, Joseph R. Hsu, Kent E. Kester, Gregory J. Martin, Leon E. Moores, William T. Obremskey, Kyle Petersen, Evan M. Renz, Jeffrey R. Saffle, Joseph S. Solomkin, Deena E. Sutter, David R. Tribble, Joseph C. Wenke, Timothy J. Whitman, Andrew R. Wiesen, Glenn W. Wortmann

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

134 Scopus citations

Abstract

Despite advances in resuscitation and surgical management of combat wounds, infection remains a concerning and potentially preventable complication of combat-related injuries. Interventions currently used to prevent these infections have not been either clearly defined or subjected to rigorous clinical trials. Current infection prevention measures and wound management practices are derived from retrospective review of wartime experiences, from civilian trauma data, and from in vitro and animal data. This update to the guidelines published in 2008 incorporates evidence that has become available since 2007. These guidelines focus on care provided within hours to days of injury, chiefly within the combat zone, to those combat-injured patients with open wounds or burns. New in this update are a consolidation of antimicrobial agent recommendations to a backbone of high-dose cefazolin with or without metronidazole for most postinjury indications, and recommendations for redosing of antimicrobial agents, for use of negative pressure wound therapy, and for oxygen supplementation in flight.

Original languageEnglish
Pages (from-to)S210-S234
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume71
Issue number2 SUPPL. 2
DOIs
StatePublished - Aug 2011

Keywords

  • Combat
  • Guidelines
  • Infection
  • Prevention
  • Trauma

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