[Prevention of infection in war wounds]. / Infektionsprophylaxe bei Kriegsverletzungen.

ABSTRACT

Medical treatment of injured patients by international missions of non-governmental organisations in crisis areas and out-of-area operations by troops, and also national disasters require special trauma management. Deviations from peacetime surgical guidelines are obligatory because of long-distance medical evacuation, the possibility of gaps in supply and the typical pattern of war injuries. Massive contamination combined with the high risk of infection is one typical attribute of wounds inflicted during a war or a disaster. In contrast to peacetime surgical guidelines, aggressive wound débridement is often needed. Timely and prophylactically prescription of a broad-spectrum antibiotic with a long half-life has great importance in the treatment of these wounds. Suitable antibiotics for these indications are piperacillin/tazobactam and ceftriazon. Nevertheless the use of antimicrobial agents will only be effective with early surgical débridement.