Prevention of infections associated with combat-related central nervous system injuries

Michael A. Forgione; Leon E. Moores; Glenn W. Wortmann; 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. Fleming; Andrew D. Green; Robert G. Hale; David K. Hayes; John B. Holcomb; Joseph R. Hsu; Kent E. Kester; Gregory J. Martin; 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

doi:10.1097/TA.0b013e318227ad86

Prevention of infections associated with combat-related central nervous system injuries

Michael A. Forgione, Leon E. Moores, Glenn W. Wortmann, 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. DunneBrian J. Eastridge, James R. Ficke, Mark E. Fleming, Andrew D. Green, Robert G. Hale, David K. Hayes, John B. Holcomb, Joseph R. Hsu, Kent E. Kester, Gregory J. Martin, 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

Research output: Contribution to journal › Review article › peer-review

10 Scopus citations

Abstract

Combat-related injuries to the central nervous system (CNS) are of critical importance because of potential catastrophic outcomes. Although the overall infection rate of combat-related CNS injuries is between 5% and 10%, the development of an infectious complication is associated with a very high morbidity and mortality. This review focuses on the prevention of infections related to injuries to the brain or the spinal cord and provides evidence-based medicine recommendations from military and civilian data for the prevention of infection from combat-related CNS injuries. Prevention strategies emphasize the importance of expert evaluation and management by a neurosurgeon as expeditiously as possible. Areas of focus include elimination of cerebrospinal fluid leaks, wound coverage, postinjury antimicrobial therapy, irrigation, and debridement. Given that these recommendations are not supported by randomized control trials or adequate cohort studies in a military population, further efforts are needed to determine the best treatment strategies. This evidence-based medicine review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.

Original language	English (US)
Pages (from-to)	S258-S263
Journal	Journal of Trauma - Injury, Infection and Critical Care
Volume	71
Issue number	2 SUPPL. 2
DOIs	https://doi.org/10.1097/TA.0b013e318227ad86
State	Published - Aug 2011
Externally published	Yes

Keywords

Central nervous system
Combat
Infection
Prevention
Trauma

ASJC Scopus subject areas

Surgery
Critical Care and Intensive Care Medicine

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10.1097/TA.0b013e318227ad86

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Forgione, M. A., Moores, L. E., Wortmann, G. W., Hospenthal, D. R., Murray, C. K., Andersen, R. C., Bell, R. B., Calhoun, J. H., Cancio, L. C., Cho, J. M., Chung, K. K., Clasper, J. C., Colyer, M. H., Conger, N. G., Costanzo, G. P., Crouch, H. K., Curry, T. K., D'Avignon, L. C., Dorlac, W. C., ... Wiesen, A. R. (2011). Prevention of infections associated with combat-related central nervous system injuries. Journal of Trauma - Injury, Infection and Critical Care, 71(2 SUPPL. 2), S258-S263. https://doi.org/10.1097/TA.0b013e318227ad86

Forgione, MA, Moores, LE, Wortmann, GW, Hospenthal, DR, Murray, CK, Andersen, RC, Bell, RB, Calhoun, JH, Cancio, LC, Cho, JM, Chung, KK, Clasper, JC, Colyer, MH, Conger, NG, Costanzo, GP, Crouch, HK, Curry, TK, D'Avignon, LC, Dorlac, WC, Dunne, JR, Eastridge, BJ, Ficke, JR, Fleming, ME, Green, AD, Hale, RG, Hayes, DK, Holcomb, JB, Hsu, JR, Kester, KE, Martin, GJ, Obremskey, WT, Petersen, K, Renz, EM, Saffle, JR, Solomkin, JS, Sutter, DE, Tribble, DR, Wenke, JC, Whitman, TJ & Wiesen, AR 2011, 'Prevention of infections associated with combat-related central nervous system injuries', Journal of Trauma - Injury, Infection and Critical Care, vol. 71, no. 2 SUPPL. 2, pp. S258-S263. https://doi.org/10.1097/TA.0b013e318227ad86

@article{63f199655ec44cc1bdcd378b6133e50f,

title = "Prevention of infections associated with combat-related central nervous system injuries",

abstract = "Combat-related injuries to the central nervous system (CNS) are of critical importance because of potential catastrophic outcomes. Although the overall infection rate of combat-related CNS injuries is between 5% and 10%, the development of an infectious complication is associated with a very high morbidity and mortality. This review focuses on the prevention of infections related to injuries to the brain or the spinal cord and provides evidence-based medicine recommendations from military and civilian data for the prevention of infection from combat-related CNS injuries. Prevention strategies emphasize the importance of expert evaluation and management by a neurosurgeon as expeditiously as possible. Areas of focus include elimination of cerebrospinal fluid leaks, wound coverage, postinjury antimicrobial therapy, irrigation, and debridement. Given that these recommendations are not supported by randomized control trials or adequate cohort studies in a military population, further efforts are needed to determine the best treatment strategies. This evidence-based medicine review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.",

keywords = "Central nervous system, Combat, Infection, Prevention, Trauma",

author = "Forgione, {Michael A.} and Moores, {Leon E.} and Wortmann, {Glenn W.} and Hospenthal, {Duane R.} and Murray, {Clinton K.} and Andersen, {Romney C.} and Bell, {R. Bryan} and Calhoun, {Jason H.} and Cancio, {Leopoldo C.} and Cho, {John M.} and Chung, {Kevin K.} and Clasper, {Jon C.} and Colyer, {Marcus H.} and Conger, {Nicholas G.} and Costanzo, {George P.} and Crouch, {Helen K.} and Curry, {Thomas K.} and D'Avignon, {Laurie C.} and Dorlac, {Warren C.} and Dunne, {James R.} and Eastridge, {Brian J.} and Ficke, {James R.} and Fleming, {Mark E.} and Green, {Andrew D.} and Hale, {Robert G.} and Hayes, {David K.} and Holcomb, {John B.} and Hsu, {Joseph R.} and Kester, {Kent E.} and Martin, {Gregory J.} and Obremskey, {William T.} and Kyle Petersen and Renz, {Evan M.} and Saffle, {Jeffrey R.} and Solomkin, {Joseph S.} and Sutter, {Deena E.} and Tribble, {David R.} and Wenke, {Joseph C.} and Whitman, {Timothy J.} and Wiesen, {Andrew R.}",

year = "2011",

month = aug,

doi = "10.1097/TA.0b013e318227ad86",

language = "English (US)",

volume = "71",

pages = "S258--S263",

journal = "Journal of Trauma - Injury, Infection and Critical Care",

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T1 - Prevention of infections associated with combat-related central nervous system injuries

AU - Forgione, Michael A.

AU - Moores, Leon E.

AU - Wortmann, Glenn W.

AU - Hospenthal, Duane R.

AU - Murray, Clinton K.

AU - Andersen, Romney C.

AU - Bell, R. Bryan

AU - Calhoun, Jason H.

AU - Cancio, Leopoldo C.

AU - Cho, John M.

AU - Chung, Kevin K.

AU - Clasper, Jon C.

AU - Colyer, Marcus H.

AU - Conger, Nicholas G.

AU - Costanzo, George P.

AU - Crouch, Helen K.

AU - Curry, Thomas K.

AU - D'Avignon, Laurie C.

AU - Dorlac, Warren C.

AU - Dunne, James R.

AU - Eastridge, Brian J.

AU - Ficke, James R.

AU - Fleming, Mark E.

AU - Green, Andrew D.

AU - Hale, Robert G.

AU - Hayes, David K.

AU - Holcomb, John B.

AU - Hsu, Joseph R.

AU - Kester, Kent E.

AU - Martin, Gregory J.

AU - Obremskey, William T.

AU - Petersen, Kyle

AU - Renz, Evan M.

AU - Saffle, Jeffrey R.

AU - Solomkin, Joseph S.

AU - Sutter, Deena E.

AU - Tribble, David R.

AU - Wenke, Joseph C.

AU - Whitman, Timothy J.

AU - Wiesen, Andrew R.

PY - 2011/8

Y1 - 2011/8

N2 - Combat-related injuries to the central nervous system (CNS) are of critical importance because of potential catastrophic outcomes. Although the overall infection rate of combat-related CNS injuries is between 5% and 10%, the development of an infectious complication is associated with a very high morbidity and mortality. This review focuses on the prevention of infections related to injuries to the brain or the spinal cord and provides evidence-based medicine recommendations from military and civilian data for the prevention of infection from combat-related CNS injuries. Prevention strategies emphasize the importance of expert evaluation and management by a neurosurgeon as expeditiously as possible. Areas of focus include elimination of cerebrospinal fluid leaks, wound coverage, postinjury antimicrobial therapy, irrigation, and debridement. Given that these recommendations are not supported by randomized control trials or adequate cohort studies in a military population, further efforts are needed to determine the best treatment strategies. This evidence-based medicine review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.

AB - Combat-related injuries to the central nervous system (CNS) are of critical importance because of potential catastrophic outcomes. Although the overall infection rate of combat-related CNS injuries is between 5% and 10%, the development of an infectious complication is associated with a very high morbidity and mortality. This review focuses on the prevention of infections related to injuries to the brain or the spinal cord and provides evidence-based medicine recommendations from military and civilian data for the prevention of infection from combat-related CNS injuries. Prevention strategies emphasize the importance of expert evaluation and management by a neurosurgeon as expeditiously as possible. Areas of focus include elimination of cerebrospinal fluid leaks, wound coverage, postinjury antimicrobial therapy, irrigation, and debridement. Given that these recommendations are not supported by randomized control trials or adequate cohort studies in a military population, further efforts are needed to determine the best treatment strategies. This evidence-based medicine review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.

KW - Central nervous system

KW - Combat

KW - Infection

KW - Prevention

KW - Trauma

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AN - SCOPUS:84863708135

SN - 0022-5282

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SP - S258-S263

JO - Journal of Trauma - Injury, Infection and Critical Care

JF - Journal of Trauma - Injury, Infection and Critical Care

IS - 2 SUPPL. 2

ER -

Prevention of infections associated with combat-related central nervous system injuries

Abstract

Keywords

ASJC Scopus subject areas

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