PubMed Health⌕ Search

Biomedical subjects

R M Coupland

Publications and source records attributed to R M Coupland.

27 records · Page 2Linked to original sources
PubMed1990

A management algorithm for chronically exposed war wounds of bone.

Chronically exposed war wounds of bone are common in field hospitals in developing countries. This algorithm aids their management. It is an extension of basic war surgery principles and takes the natural history of wounds into account. The importance of excision of dead bone is stressed. Methods of fracture immobilization and reconstruction are considered. The management of chronic bone exposure by basic principles is considered in relation to a multispecialist approach to severe open tibial fractures in civilian practice.

Algorithms↗
PubMed1989

Technical aspects of war wound excision.

Excision of war wounds may be performed by civilian surgeons with no previous experience of war surgery. The principles of complete excision of non-viable tissue with removal of foreign material, leaving the wound open, and delayed primary closure of skin are vitally important. A major part of the surgical approach is wound assessment and the formation of an operative plan. The extent and ease of the operation depends on the site, age and type of wound. Attention to the technique of wound excision avoids septic complications and permits skin closure when the first dressing is removed. Wounds may need re-excision at a later date. Modification of surgical management is necessary when certain difficult areas are wounded and when the patient presents after many days or has suffered inappropriate first aid.

Blast Injuries↗
PubMed1989

Amputation for antipersonnel mine injuries of the leg: preservation of the tibial stump using a medial gastrocnemius myoplasty.

Antipersonnel mines are very commonly used in modern warfare. They produce a recognisable pattern of injury to the leg, which frequently spares the gastrocnemius muscle. Surgical amputation is often indicated. Medial gastrocnemius myoplastic below-knee amputation is suitable for these injuries. The technique permits cover and preservation of an acceptable tibial stump.

Amputation, Surgical↗
PubMed1988

An experience of war surgery and wounds presenting after 3 days on the border of Afghanistan.

The International Committee of the Red Cross (ICRC) has run hospitals for the wounded of the conflict in Afghanistan since 1981. For political and geographical reasons the hospitals are situated in Pakistan, some distance from the fighting, and so the wounded may take many days to arrive. This has enabled a surgical team provided by the British Red Cross Society to observe wounds of varying age and degrees of putrefaction or healing. Twenty-nine (29) patients with wounds of 3 or more days are detailed. The old wounds showed a tendency either to putrefaction or healing and the surgical management had to be revised accordingly. Wounds sutured in the field tended to putrefy. Among the various problems, the most taxing and difficult were the cultural and religious objections to amputation. The ICRC is committed to providing surgical hospitals for the Afghan war wounded for as long as the conflict lasts. It has adapted the local facilities and staff to the particular political, geographical and cultural situation.

Adult↗
PubMed1986

Sutures versus staples in skin flap operations.

Apposition of skin edges in plastic surgical procedures can be achieved by sutures or stainless steel staples. This retrospective study reviews 45 skin falp operations and finds that 20.6% of sutured flaps are complicated by partial necrosis or slow healing. These complications occur in 62.5% of stapled flaps. It is proposed that crimping of the skin edges by the staples results in tension across the flap. This mechanism is demonstrated on cadaver skin. The efficacy of staples in closure of surgical incisions is recognised, but this study does not favour their use on skin flaps.

Humans↗
PubMed1984

Short term review of the De La Caffiniere trapeziometacarpal arthroplasty.

We present a short term review of twenty-one De La Caffinière trapezio-metacarpal prostheses inserted into twenty patients with an average review time of fifteen months. Only one case was of rheumatoid arthritis and the main indication for operation was pain. From a functional and symptomatic point of view the results are similar to other series with surgery for trapezio-metacarpal arthritis but due to cup loosening 24% have needed revision, 24% have loose cups and a further 19% have lucent cement lines around the cup. This review draws attention to the worrying frequency of loosening with this prosthesis.

Adult↗
PubMedDate not supplied

The Red Cross classification of war wounds: the E.X.C.F.V.M. scoring system.

The Red Cross classification of war wounds is based upon features of the wound, not upon weaponry. It is proposed as a new means of understanding, communicating, and gathering information about war wounds and their management. The wound score is based on the skin wounds and the presence of a cavity, fracture, vital injury, or metallic bodies in the wound. All wounds so scored can be graded according to severity and typed according to structures injured; consequently, wounds are identified by their clinical significance. A study of 247 wounds shows the feasibility of scoring wounds in the field and yields surgically relevant information about bullet and fragment wounds. The applications of the classification are to wound assessment, establishing a scientific basis to war surgery, surgical audit, and collecting wound data from the field.

Humans↗