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Hamel JF, Joris J, Slim K, Régimbeau JM, Cotte E, Léger M, Venara A, Agut E, Alfonsi P, Alili A, Amraoui J, Andre A, Arimon JM, Arnalsteen L, Asztalos R, Audouy C, Aumont O, Auvray S, Baietto H, Balbo G, Aguilera MB, Beaupel N, Beaupel N, Lazreg ZB, Beguinot-Holtzscherer S, Beller JP, Bellouard A, Henda IB, Bentamene M, Bernard P, Berthon N, Biblocque A, Bievre T, Bilosi M, Blanc B, Blatt A, Blehaut D, Bock A, Bongiovanni JP, Bonnet M, Bouarroudj N, Boissier D, Boret H, Borg R, Bouchair Z, Bouchard F, Boumadani M, Bounicaud D, Bourdeix O, Bourseau JC, Bozio G, Brachet D, Brek A, Briez N, Buisset-Subiran C, Calvet B, Cartaux-Taieb A, Castiglioni M, Catinois M, Du Rieu MC, Chalumeau C, Chambrier G, Chamlou R, Chapel N, Chenet P, Chirac P, Chokkairi S, Chopin X, Christou N, Chuffart E, Corfiotti F, Craus C, Cuellar E, Dardenne G, de Angelis N, de Ioro U, Dechanet F, Dellis R, Demasles L, Denet C, Deroo B, Desfourneaux-Denis V, Dileon S, Douard R, Dorado C, Dorscheid E, Dumont F, Durame F, Duchalais E, Dupre A, Dufraisse S, Elghali MA, Hutin E, Emna A, Essome E, Fabre N, Faivre V, Faucheron JL, Favoulet P, Fernou P, Firtion O, Flamein R, Florea S, de la Fontaine C, Forestier D, Fourn E, Frentiu DV, Frisoni R, Frisoni A, Gautier T, Genty F, Georgeanu S, Germain A, Gibert S, Gilbert B, Gignoux B, Goasguen N, Goubault P, Gres P, Guedj J, Guignard B, Gugenheim J, Guaquiere C, Guiot JL, Guinier D, Hail K, Hatwel C, Iatan E, Janecki T, Jany T, Jaspart J, Journe F, Jouffret L, Kassoul A, Kattou F, Keller P, Knepfler T, Khouri T, Kothonidis K, Landreau P, Langlois G, Le Bartz G, Lebas S, Leonard D, Leonard D, Leporrier J, Lescure G, Lewandowski R, Liddo A, Longeville JH, Lucescu I, Mariani A, Mariani P, Martin G, Martinet O, Massalou D, Massard JL, Mauvais F, Mazza D, Katapile JM, Milou F, Mirre F, Martinez CM, Mensier A, Mergui C, Mestrallet JP, Meyer C, Mocellin N, Montagne S, Naseef O, Orville M, Ostermann-Bucher S, Ouaissi M, Paqueron X, Paquet C, Passebois L, Pichot-Delahaye V, Pillet M, Pottie JC, Plard L, Plumereau F, Poincenot J, Poisblanc M, Poupard B, Proske JM, Puche P, Raspado O, Riboud R, Rakotoarisoa B, Raynaud K, Razafindratsira T, Renaud M, Rio D, Rio D, Ripoche J, Roussel B, Denis MS, Salaun P, Sage PY, Scherrer ML, Sirisier F, Smeets B, Smejkal M, Steinmetz JP, Tavernier M, Thievenaz R, Tirca M, Toque L, Triki E, Tzanis D, Vacher B, Vanwymeersch S, Vauclair E, Verhaeghe R, Vetrila V, Vieuille C, Vermeulen F, Vignal JC, Voilin C, de Wailli P, Wolthuis A, Zaepfel S. Transversus Abdominis Block or Wound Infiltration Should be Performed in Colorectal Surgery Patients in an Enhanced Recovery Setting: a Propensity Score Analysis of a National Database. J Gastrointest Surg 2022; 27:798-802. [PMID: 36376728 DOI: 10.1007/s11605-022-05514-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Jean-Francois Hamel
- Department of Biostatistics, Maison de La Recherche, University Hospital of Angers, 4 Rue Larrey, Cedex 9, 49933, Angers, France.,Faculty of Health, Department of Medicine, Angers, France
| | - Jean Joris
- Department of Anesthesiology, CHU Liège, Liège, Belgium
| | - Karem Slim
- Department of Visceral Surgery, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France
| | - Jean Marc Régimbeau
- Service de Chirurgie Digestive, CHU Amiens Picardie Et Université de Picardie Jules Verne, Amiens, France.,Unité de Recherche Clinique SSPC (Simplifications Des Soins Des Patients Complexes) UR UPJV 7518, Université de Picardie Jules Verne, Amiens, France
| | - Eddy Cotte
- Department of Visceral Surgery, CHU Lyon, Centre Hospitalier Lyon-Sud, 69495, Pierre-Bénite Cedex, France.,Université de Lyon, Lyon, France
| | - Maxime Léger
- Faculty of Health, Department of Medicine, Angers, France.,Department of Anesthesiology, University Hospital of Angers, 4 Rue Larrey, Cedex 9, 49933, Angers, France
| | - Aurélien Venara
- Faculty of Health, Department of Medicine, Angers, France. .,Department of Visceral and Endocrinal Surgery, University Hospital of Angers, 4 Rue Larrey, Cedex 9, 49933, Angers, France. .,IHFIH, UPRES EA 3859, University of Angers, Angers, France.
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Larréché S, Bousquet A, Soler C, Mac Nab C, de Briel D, Delaune D, Bigaillon C, Pasquier P, Dubost C, Demoures T, Malgras B, Ausset S, de Rudnicki S, Leclerc T, de Loynes B, Bonnet S, Mocellin N, Ficko C, Haus R, Hersan O, Rigal S, Mérens A. Microbiology of French military casualties repatriated from overseas for an open traumatic injury. Med Mal Infect 2018; 48:403-409. [PMID: 29709404 DOI: 10.1016/j.medmal.2018.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND This study aimed to describe the microbiological epidemiology of repatriated French soldiers with an open traumatic injury, and to measure the proportion of multidrug-resistant bacteria (MDRB). METHODS Retrospective study including all French soldiers repatriated in 2011 and 2012 in Parisian military hospitals for open traumatic injury. Results of clinical samples and MDRB screening were collected. The antibiotic susceptibility was assessed using the agar disk diffusion method. Characterization of resistance mechanisms was performed using PCR. Genotyping of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) isolates was performed using rep-PCR. RESULTS A total of 139 patients were included; 70% of them were repatriated from Afghanistan. At admission, 24/88 were positive for MDRB (28%), mainly ESBL-E but no carbapenemase-producing Enterobacteriaceae and vancomycin-resistant Enterococcus faecium were identified. Forty-five patients had lesion sample collection, and 28/45 had a positive culture. The most frequently isolated pathogens were Enterobacter cloacae, Pseudomonas aeruginosa, and Escherichia coli. For eight patients, a MDRB was isolated from the wound, mainly ESBL-E (7/8) but also one methicillin-resistant Staphylococcus aureus and one imipenem-resistant Acinetobacter baumannii. Among ESBL-E, the PCR evidenced the high prevalence of CTX-M15 enzymes. Rep-PCR performed on the 23 ESBL-producing E. coli isolates highlighted numerous profiles. CONCLUSIONS Controlling the spread of ESBL-E is currently challenging for French Armed Forces. Despite any evidence of an epidemic clone, a high-level compliance with hygiene precautions is required throughout the chain of care to avoid cross contamination.
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Affiliation(s)
- S Larréché
- Microbiologie, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France.
| | - A Bousquet
- Microbiologie, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France
| | - C Soler
- Microbiologie, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - C Mac Nab
- Microbiologie, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - D de Briel
- Microbiologie, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France; Microbiologie, hôpitaux civils de Colmar, 39, avenue de la Liberté, 68024 Colmar, France
| | - D Delaune
- Microbiologie, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France
| | - C Bigaillon
- Microbiologie, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France
| | - P Pasquier
- Anesthésie-réanimation, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France; Anesthésie-réanimation, Hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75005, Paris, France
| | - C Dubost
- Anesthésie-réanimation, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France
| | - T Demoures
- Chirurgie orthopédique, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France
| | - B Malgras
- École du Val-de-Grâce, 1, place Alphonse-Laveran, 75005, Paris, France; Chirurgie viscérale, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France
| | - S Ausset
- Anesthésie-réanimation, Hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75005, Paris, France
| | - S de Rudnicki
- Anesthésie-réanimation, Hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - T Leclerc
- École du Val-de-Grâce, 1, place Alphonse-Laveran, 75005, Paris, France; Centre de traitement des brulés, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - B de Loynes
- Chirurgie orthopédique, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - S Bonnet
- École du Val-de-Grâce, 1, place Alphonse-Laveran, 75005, Paris, France; Chirurgie viscérale, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France; Chirurgie viscérale, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - N Mocellin
- Chirurgie viscérale, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - C Ficko
- Maladies infectieuses et tropicales, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France
| | - R Haus
- Direction centrale du service de santé des armées, 158, cours des Maréchaux, 94300 Vincennes, France
| | - O Hersan
- Direction centrale du service de santé des armées, 158, cours des Maréchaux, 94300 Vincennes, France
| | - S Rigal
- École du Val-de-Grâce, 1, place Alphonse-Laveran, 75005, Paris, France; Chirurgie orthopédique, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - A Mérens
- Microbiologie, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75005, Paris, France
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Hornez E, Béranger F, Monchal T, Baudouin Y, Boddaert G, De Lesquen H, Bourgouin S, Goudard Y, Malgras B, Pauleau G, Reslinger V, Mocellin N, Natale C, Meyrat L, Avaro JP, Balandraud P, Gaujoux S, Bonnet S. Management specificities for abdominal, pelvic and vascular penetrating trauma. J Visc Surg 2017; 154:S1878-7886(17)30126-1. [PMID: 29239852 DOI: 10.1016/j.jviscsurg.2017.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Management of patients with penetrating trauma of the abdomen, pelvis and their surrounding compartments as well as vascular injuries depends on the patient's hemodynamic status. Multiple associated lesions are the rule. Their severity is directly correlated with initial bleeding, the risk of secondary sepsis, and lastly to sequelae. In patients who are hemodynamically unstable, the goal of management is to rapidly obtain hemostasis. This mandates initial laparotomy for abdominal wounds, extra-peritoneal packing (EPP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) in the emergency room for pelvic wounds, insertion of temporary vascular shunts (TVS) for proximal limb injuries, ligation for distal vascular injuries, and control of exteriorized extremity bleeding with a tourniquet, compressive or hemostatic dressings for bleeding at the junction or borderline between two compartments, as appropriate. Once hemodynamic stability is achieved, preoperative imaging allow more precise diagnosis, particularly for retroperitoneal or thoraco-abdominal injuries that are difficult to explore surgically. The surgical incisions need to be large, in principle, and enlarged as needed, allowing application of damage control principles.
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Affiliation(s)
- E Hornez
- Service de chirurgie viscérale et générale, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France
| | - F Béranger
- Service de chirurgie thoracique et vasculaire, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France
| | - T Monchal
- Service de chirurgie viscérale, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France
| | - Y Baudouin
- Service de chirurgie viscérale et générale, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France
| | - G Boddaert
- Service de chirurgie thoracique et vasculaire, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France
| | - H De Lesquen
- Service de chirurgie thoracique et vasculaire, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France
| | - S Bourgouin
- Service de chirurgie viscérale, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France
| | - Y Goudard
- Service de chirurgie digestive, endocrinienne et métabolique, HIA Laveran, 13013 Marseille, France
| | - B Malgras
- Service de chirurgie viscérale, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France
| | - G Pauleau
- Service de chirurgie digestive, endocrinienne et métabolique, HIA Laveran, 13013 Marseille, France
| | - V Reslinger
- Service de chirurgie viscérale et générale, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France
| | - N Mocellin
- Service de chirurgie viscérale et générale, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France
| | - C Natale
- Service de chirurgie thoracique et vasculaire, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France
| | - L Meyrat
- Service de chirurgie thoracique et vasculaire, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France
| | - J-P Avaro
- Service de chirurgie thoracique et vasculaire, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75230 Paris cedex 05, France
| | - P Balandraud
- Service de chirurgie viscérale, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75230 Paris cedex 05, France
| | - S Gaujoux
- Service de chirurgie digestive, hépatobiliaire et endocrinienne, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - S Bonnet
- Service de chirurgie viscérale et générale, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75230 Paris cedex 05, France.
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Hornez E, Boddaert G, Ngabou UD, Aguir S, Baudoin Y, Mocellin N, Bonnet S. Temporary vascular shunt for damage control of extremity vascular injury: A toolbox for trauma surgeons. J Visc Surg 2015; 152:363-8. [PMID: 26456452 DOI: 10.1016/j.jviscsurg.2015.09.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
In an emergency, a general surgeon may be faced with the need to treat arterial trauma of the extremities when specialized vascular surgery is not available in their hospital setting, either because an arterial lesion was not diagnosed during pre-admission triage, or because of iatrogenic arterial injury. The need for urgent control of hemorrhage and limb ischemia may contra-indicate immediate transfer to a hospital with a specialized vascular surgery service. For a non-specialized surgeon, hemostasis and revascularization rely largely on damage control techniques and the use of temporary vascular shunts (TVS). Insertion of a TVS is indicated for vascular injuries involving the proximal portion of extremity vessels, while hemorrhage from distal arterial injuries can be treated with simple arterial ligature. Proximal and distal control of the injured vessel must be obtained, followed by proximal and distal Fogarty catheter thrombectomy and lavage with heparinized saline. The diameter of the TVS should be closely approximated to that of the artery; use of an oversized TVS may result in intimal tears. Systematic performance of decompressive fasciotomy is recommended in order to prevent compartment syndrome. In the immediate postoperative period, the need for systematic use of anticoagulant or anti-aggregant medications has not been demonstrated. The patient should be transferred to a specialized center for vascular surgery as soon as possible. The interval before definitive revascularization depends on the overall condition of the patient. The long-term limb conservation results after placement of a TVS are identical to those obtained when initial revascularization is performed.
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Affiliation(s)
- E Hornez
- Hôpital d'Instruction des Armées Percy, Clamart, France.
| | - G Boddaert
- Hôpital d'Instruction des Armées Percy, Clamart, France
| | - U D Ngabou
- Hôpital d'Instruction des Armées Percy, Clamart, France
| | - S Aguir
- Hôpital d'Instruction des Armées Percy, Clamart, France
| | - Y Baudoin
- Hôpital d'Instruction des Armées Percy, Clamart, France
| | - N Mocellin
- Hôpital d'Instruction des Armées Percy, Clamart, France
| | - S Bonnet
- Hôpital d'Instruction des Armées Percy, Clamart, France
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Hornez E, Ramiara P, Mocellin N, Bajard X, Legoudeveze S, Charpail C, Ollat D. Surgical management of Syria's war casualties: experience from a French surgical team deployed in the Zaatari refugee camp (Jordan). Eur J Trauma Emerg Surg 2014; 41:143-7. [PMID: 26038257 DOI: 10.1007/s00068-014-0424-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 06/02/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE In August 2012, the Zaatari refugee camp was opened in Jordan under the auspices of the United Nations High Commissioner for Refugees. France deployed there a surgical facility to treat victims of war trauma. METHODS After a phase of intensive care and resuscitation, surgical management meeting the current standards of war surgery was conducted. Then, patients were transferred to a Jordanian civilian hospital or stayed in the Zaatari camp. A retrospective analysis of patient data was performed. RESULTS From January to March 2013, 95 patients were managed: 85% of patients were male with a median age of 27 years (4-65); 5% of patients were <18 years of age. All patients were Syrian, civilian or members of the "Free Syrian Army." Penetrating trauma accounted for 95% of lesions. A total of 105 surgeries were performed, including: 33 external fixators, 8 laparotomies, 8 nerve repairs, 6 cover flaps, 4 direct arterial repairs, 2 reversed saphenous vein bypass grafts, and 1 amputation. The median length of stay on the wards was 3.71 days; 43% of patients were transferred to Jordanian civilian hospitals. CONCLUSIONS The presence at the Zaatari camp of a surgical facility, which is experienced and specialized in war surgery, is essential, as long as battles are ongoing. Many victims will later require long-term surgical care for the management of the sequelae associated with these traumas.
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Affiliation(s)
- E Hornez
- 6ème Antenne Chirurgicale Aérotransportable, Service de chirurgie thoracique et viscérale, Hôpital d'Instruction des Armées PERCY, 101 Boulevard Henri Barbusse, 92140, Clamart, France,
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Mlynski A, Mocellin N, Imperato M, Molimard B, Bordier E, Menguy P, Baranger B. Treatment of a Ballistic Wound of the Common Carotid Artery Revealed by a Spontaneous Carotid–Jugular Fistula. Ann Vasc Surg 2011; 25:269.e9-12. [DOI: 10.1016/j.avsg.2010.03.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2009] [Revised: 03/22/2010] [Accepted: 03/22/2010] [Indexed: 11/24/2022]
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