Wounds and Injuries Clinical Trial
Official title:
Outcome for Patients With War-Associated Extremity Wound Infection
Extremity wounds and fractures constitute the majority of war-associated traumatic injuries, both for civilians and combatants. War-associated injuries are often contaminated with foreign material, leading to infection. Wound infections is considered a major risk to life and restoration of function in war-wounded patients surviving past the first hours. In a cohort study the investigators aim to assess whether the infection itself affects patient outcome (i.e. amputation, death) when comparing patients with and patients without infection.
Armed violence has occurred intermittently in northwestern Pakistan and neighboring
Afghanistan since the beginning of the 1980s. In 1981 the International Committee of the Red
Cross (ICRC) opened a hospital in Peshawar, Pakistan, to care for the injured from the armed
conflict in Afghanistan. In 2004 the number of patients increased as a result of the emerging
divergence between the State of Pakistan and militant groups in the Northwestern Pakistan.
Yearly about 1000 patients with war-associated injuries, predominantly caused by gunshots and
explosive devices have been treated for free at the ICRC hospital in Peshawar. The hospital
is now closed.
War-associated injuries are generally treated according to the ICRC war surgical protocol.
Research on the epidemiology of and risk factors for wound infection in patients with
war-associated injuries is limited and primarily include military combatants, leading to a
selection of young males. Due to the use of body armor and forward surgical teams this data
may not be applicable to a civilian setting. It is unknown to what extent wound infection
itself is a factor contributing to serious complications such as amputation and death.
Knowledge is needed to gear resources towards those most in need. This research makes use of
a unique database that contains both civilians and combatants of both sexes and all ages. The
investigators aim to assess whether the infection itself affects patient outcome (i.e.
amputation, death) when comparing patients with and patients without infection.
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