Clinical and microbiological profiles of anti-personnel mine injuries in the Medellín area of northwestern Colombia
Keywords:
heridas y traumatismos, traumatismo múltiple, traumatismos por explosión, amputación, infección
Abstract
Introduction. The counts of antipersonnel mine injuries are increasing worldwide, but in Colombia, documentation of the clinical and microbiological characteristics of these lesions is lacking.Objectives. To determine the clinical and microbiological characteristics of antipersonnel mine injuries for patients admitted for treatment during a 2 and a half year period.
Materials and methods. The medical records were reviewed for 151 patients hospitalized with injuries caused by antipersonnel mines. The admissions occurred between January 1st 2003 and July 31st 2005 at a highly specialized university hospital, the Pablo Tobón Uribe Hospital in Medellín, Colombia.
Results. All patients were male, mean age 24 years old, and all but 8 of them military. The length of stay averaged 20 days and hospital mortality 4%. Multiple lesions occurred in 66.8% of the cases, 88.0% of the injuries affected the limbs, and amputations were mandated in 52.3% of patients. A total of 313 specimens were cultured--68.7% of cultures were positive, and 386 microorganisms were identified. The most prevalent bacteria in the first culture were Pseudomonas aeruginosa and Escherichia coli. In subsequent cultures, P. aeruginosa and Enterococcus faecalis appeared. Most of the patients (93.4%) received standard antibiotic therapy, ampicillin/sulbactam.
Conclusions. The clinical and microbiological characteristics of patients were related to their military occupation and the complex injuries produced by the mines. Knowledge of these characteristics will permit the design of better management strategies and empirical treatments.
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References
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2. Giannou C. Antipersonal landmines: facts, fictions and priorities. BMJ.1997;315:1453-4.
3. Vidal JL. Fundamentos terapéuticos actuales para los heridos de extremidades durante la guerra. Rev Cubana Med Milit.1999;28:31-40.
4. Williams J. Las minas terrestres y su eliminación. Revista Internacional de la Cruz Roja. 1995;130:409-27.
5. Cauderay G. Las minas antipersonal. Revista Internacional de la Cruz Roja.1993;118:289-305.
6. Comité Internacional de la Cruz Roja. Para poner fin a la era de las minas terrestres. América: Panorama y perfiles de los países. Ginebra: CICR; 2004.
7. De Colombia Amigos. Las minas antipersona: el terror que azota a Colombia. Fecha de consulta: 30 de agosto de 2009. Disponible en: http://decolombiaamigos.com/index.php?view=article&catid=37%3Ainformesdebase&id=53%3Alas-minas-antipersona-un-drama colombiano&option=com_content&Itemid=56.
8. Krug E, Ikeda R, Qualls M, Anderson MA, Rosenberg ML, Jackson RJ. Preventing land mine-related injury and disability: a public health perspective. JAMA. 1998;280:465-6.
9. Landmine Monitor. International campaign to ban landmines. Colombia. 2009 Fecha de acceso: 30 de agosto de 2009. Disponible en: http://www.lm.icbl.org/index.php.
10. Vicepresidencia de la República de Colombia. Programa Presidencial de los Derechos Humanos y Derecho Internacional Humanitario. Observatorio de Minas. Fecha de consulta: 30 de agosto de 2009. Disponible en: http://www.derechoshumanos.gov.co/PNA/estadisticasminas.asp.
11. Vicepresidencia de la República de Colombia. Programa Presidencial de los Derechos Humanos y Derecho Internacional Humanitario. Observatorio de los Derechos Humanos en Colombia. Fecha de consulta: 30 de agosto de 2009. Disponible en: http://derechos humanos.gov.co/observatorio/.
12. Clasper J, Rew D. Trauma life support in conflict. BMJ. 2003;327:1178-9.
13. Organización Mundial de la Salud. Clasificación Estadística Internacional de Enfermedades y Problemas de Salud Conexos (CIE). Décima Revisión (CIE-10). Ginebra: OMS; 1992.
14. American Society for Microbiology. Clinical microbiology procedures. Handbook. Second edition. Washington, D.C.: American Society for Microbiology; 2004.
15. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; CLSI document M100-S19. Wayne, PA: CLSI; 2005.
16. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections. En: Olmsted RN, editor. APIC Infection Control and Applied Epidemiology: Principles and Practice. St. Louis: Mosby; 1996. p. A1-20.
17. Coupland R, Russbach R. Victims of antipersonal mines: What is being done? Med Glob Surviv. 1994;1:18-22.
18. Wennerstrom M. Injuries associated with landmines and unexploded ordnance-Afghanistan, 1997-2002. JAMA. 2003;290:1846-8.
19. Dufour D, Kromann-Jensen S, Owen-Smith M, Salmela J, Steneng GF, Zetterström B. Surgery for victims of war. Third edition. Ginebra: CICR; 1998.
20. Bowler PG, Buerden BI, Armstrong DG. Wound microbiology and associated approaches to wound management. Clin Microbiol Rev. 2001;14:244-69.
21. Champion H, Bellamy R, Roberts C, Leppaniemi A. A profile of combat injury. J Trauma. 2003;54:S13-9.
22. Brown R, Chaloner E, Mannion S, Cheatle T. 10-year experience of injuries sustained during clearance of antipersonnel mines. Lancet. 2001;358:2048-9.
23. Sulayvani F. Antipersonnel land mines injuries in Dohuk region/northern Iraq. The Middle East Journal of Emergency Medicine. 2001;1:6.
How to Cite
1.
Restrepo AC, López JA. Clinical and microbiological profiles of anti-personnel mine injuries in the Medellín area of northwestern Colombia. biomedica [Internet]. 2010 Sep. 30 [cited 2024 May 21];30(3):338-44. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/267
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Published
2010-09-30
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Original articles
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