Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-18T11:56:54.257Z Has data issue: false hasContentIssue false
  • English
  • Français

Disaster-Related Injury Management: High Prevalence of Wound Infection After Super Typhoon Haiyan

Published online by Cambridge University Press:  02 September 2015

Yong Won Kim Open the ORCID record for Yong Won Kim [Opens in a new window] ,
Seong Yeop Kim ,
Hoon Kim ,
Moo Eob Ahn ,
Kang Hyun Lee Open the ORCID record for Kang Hyun Lee [Opens in a new window]  and
Eun Seok Hong
Yong Won Kim
Affiliation:
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea
Seong Yeop Kim
Affiliation:
Department of General Surgery, Wonju College of Medicine, Yonsei University, Republic of Korea
Hoon Kim
Affiliation:
Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Republic of Korea
Moo Eob Ahn
Affiliation:
Department of Emergency Medicine, College of Medicine, Hanlim University, Republic of Korea
Kang Hyun Lee
Affiliation:
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea
Eun Seok Hong*
Affiliation:
Department of Emergency Medicine, College of Medicine, Ulsan University, Republic of Korea.
*
Correspondence and reprint requests to Eun Seok Hong, MD, Department of Emergency Medicine, College of Medicine, Ulsan University, 877 Jeonha-dong, Dong-gu, Ulsan 682-714, Republic of Korea (e-mail: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

After Super Typhoon Haiyan, a category 5 tropical cyclone, insufficient resources were available for medical management. Many patients in the Philippines were wounded as a result of the disaster. We examined the prevalence, risk factors, and consequences of disaster-related wounds and wound infection in the post-disaster period.

Methods

We performed a retrospective review of consecutive patients admitted to a Korean Disaster Relief Team clinic at St. Paul’s Hospital, Tacloban City, Republic of Philippines, between December 9 and 13, 2013. Traumatic injury patients were included; patients not exhibiting a wound were excluded.

Results

Of the 160 patients enrolled in the study, 71 (44.4%) had infected wounds. There were no significant differences in the age, sex, past medical history, wound site, wound depth, injury mechanism, or inducer of injury between the uninfected and infected groups. In the univariate analysis, a foreign-body-contaminated wound, a chronic wound, elapsed time from injury to medical contact, an inadequately cared for wound, and need for subsequent wound management were associated with wound infection (P<0.05). The multivariate analysis revealed that foreign body contamination and having an inadequately cared for wound were associated with wound infection (odds ratio [OR]: 10.12, 95% confidence interval [CI]: 3.59-28.56; OR: 3.51, 95% CI: 1.07-11.51, respectively).

Conclusion

In the post-disaster situation, many wound infections required definitive care. Wound infection was associated with inadequately cared for wounds and foreign-body-contaminated wounds. (Disaster Med Public Health Preparedness. 2016;10:28–33)

Keywords

tropical stormwounds and injuriesnatural disasters
Type
Brief Reports
Information
Disaster Medicine and Public Health Preparedness , Volume 10 , Issue 1 , February 2016 , pp. 28 - 33
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. SitRep No. 73 Effects of Typhoon “Yolanda” (Haiyan). Situational reports re effects of Typhoon Yolanda (Haiyan). National Disaster Risk Reduction and Management Council website. http://www.ndrrmc.gov.ph/index.php/21-disaster-events/1329-situational-report-re-effects-of-typhoon-yolanda-haiyan. Published December 18, 2013. Accessed August 11, 2015.Google Scholar
2. Fischetti, M. Was Typhoon Haiyan a record storm? Scientific American. http://blogs.scientificamerican.com/observations/was-typhoon-haiyan-a-record-storm/. Published November 12, 2013. Accessed August 11, 2015.Google Scholar
3. Millie, M, Senkowski, C, Stuart, L, et al. Tornado disaster in rural Georgia: triage response, injury patterns, lessons learned. Am Surg. 2000;66:223-228.CrossRefGoogle ScholarPubMed
4. Uscher-Pines, L, Vernick, JS, Curriero, F, Lieberman, R, Burke, TA. Disaster-related injuries in the period of recovery: the effect of prolonged displacement on risk of injury in older adults. J Trauma. 2009;67(4):834-840. http://dx.doi.org/10.1097/TA.0b013e31817f2853.Google ScholarPubMed
5. Xu, Y, Huang, J, Zhou, J, Zeng, Y. Patterns of abdominal injury in 37 387 disaster patients from the Wenchuan earthquake. Emerg Med J. 2013;30(7):538-542. http://dx.doi.org/10.1136/emermed-2012-201300.CrossRefGoogle Scholar
6. Phalkey, R, Reinhardt, JD, Marx, M. Injury epidemiology after the 2001 Gujarat earthquake in India: a retrospective analysis of injuries treated at a rural hospital in the Kutch district immediately after the disaster. Glob Health Action. 2011;4(00):7196. http://dx.doi.org/10.3402/gha.v4i0.7196.Google Scholar
7. Whyte, AG. Letter: disaster wound treatment. BMJ. 1975;4(5987):43-44. http://dx.doi.org/10.1136/bmj.4.5987.43-b.Google Scholar
8. Robson, MC. Wound infection. A failure of wound healing caused by an imbalance of bacteria. Surg Clin North Am. 1997;77(3):637-650. http://dx.doi.org/10.1016/S0039-6109(05)70572-7.Google Scholar
9. Norris, SO, Provo, B, Stotts, NA. Physiology of wound healing and risk factors that impede the healing process. AACN Clin Issues Crit Care Nurs. 1990;1:545-552.Google Scholar
10. Dryden, SV, Shoemaker, WG, Kim, JH. Wound management and nutrition for optimal wound healing. Atlas Oral Maxillofac Surg Clin North Am. 2013;21(1):37-47. http://dx.doi.org/10.1016/j.cxom.2012.12.008.CrossRefGoogle ScholarPubMed
11. Brem, H, Jacobs, T, Vileikyte, L, et al. Wound-healing protocols for diabetic foot and pressure ulcers. Surg Technol Int. 2003;11:85-92.Google ScholarPubMed
12. Perencevich, EN, Sands, KE, Cosgrove, SE, Guadagnoli, E, Meara, E, Platt, R. Health and economic impact of surgical site infections diagnosed after hospital discharge. Emerg Infect Dis. 2003;9(2):196-203. http://dx.doi.org/10.3201/eid0902.020232.CrossRefGoogle ScholarPubMed
13. Whitehouse, JD, Friedman, ND, Kirkland, KB, et al. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol. 2002;23:183-189.CrossRefGoogle Scholar
14. Kirkland, KB, Briggs, JP, Trivette, SL, et al. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999;20:725-730.Google Scholar
15. Poulsen, KB, Bremmelgaard, A, Sorensen, AI, Raahave, D, Petersen, JV. Estimated costs of postoperative wound infections. A case-control study of marginal hospital and social security costs. Epidemiol Infect. 1994;113(02):283-295. http://dx.doi.org/10.1017/S0950268800051712.Google Scholar
16. Vegas, AA, Jodra, VM, Garcia, ML. Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization. Eur J Epidemiol. 1993;9:504-510.Google Scholar
17. Ennis, WJ. Disaster management, triage-based wound care, and patient safety: reflections on practice following an earthquake. Ostomy Wound Manage. 2010;56:61-69.Google Scholar
18. Liu, HQ, Yang, SM, Xu, H, et al. Investigation and management of wound on head and neck from the disaster area in Wenchuan earthquake. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008;43:643-646.Google Scholar
19. Maegele, M, Gregor, S, Yuecel, N, et al. One year ago not business as usual: wound management, infection and psychoemotional control during tertiary medical care following the 2004 Tsunami disaster in southeast Asia. Crit Care. 2006;10(2):R50. http://dx.doi.org/10.1186/cc4868.CrossRefGoogle Scholar
20. Okumura, J, Kai, T, Hayati, Z, et al. Antimicrobial therapy for water-associated wound infections in a disaster setting: gram-negative bacilli in an aquatic environment and lessons from Banda Aceh. Prehosp Disaster Med. 2009;24:189-196.Google Scholar
21. Lim, PL. Wound infections in tsunami survivors: a commentary. Ann Acad Med Singapore. 2005;34:582-585.Google Scholar
22. Levy, MJ, Tang, N. Use of tissue adhesive as a field expedient barrier dressing for hand wounds in disaster responders. Prehosp Disaster Med. 2014;29(1):107-109. doi: 10.1017/S1049023X13009205.Google Scholar
23. Missair, A, Pretto, EA, Visan, A, et al. A matter of life or limb? A review of traumatic injury patterns and anesthesia techniques for disaster relief after major earthquakes. Anesth Analg. 2013;117(4):934-941. http://dx.doi.org/10.1213/ANE.0b013e3182a0d7a7.Google Scholar
24. Afshar, M, Raju, M, Ansell, D, Bleck, TP. Narrative review: tetanus-a health threat after natural disasters in developing countries. Ann Intern Med. 2011;154(5):329-335. http://dx.doi.org/10.7326/0003-4819-154-5-201103010-00007.CrossRefGoogle ScholarPubMed
25. Firth, PG, Solomon, JB, Roberts, LL, et al. Airway management of tetanus after the Haitian earthquake: new aspects of old observations. Anesth Analg. 2011;113:545-547.Google Scholar
26. Sutiono, AB, Qiantori, A, Suwa, H, Ohta, T. Characteristic tetanus infection in disaster-affected areas: case study of the Yogyakarta earthquakes in Indonesia. BMC Res Notes. 2010;3(1):8. http://dx.doi.org/10.1186/1756-0500-3-8.Google Scholar