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Masquelet technique in military practice:specificities and future directions for combat-related bone defect reconstruction

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Military Medical Research 2023年第3期10卷 369-382页

作者： Laurent Mathieu Romain Mourtialon Marjorie Durand Arnaud de Rousiers Nicolas de l’Escalopier Jean‑Marc Collombet Department of Orthopedic Trauma and Reconstructive SurgeryPercy Military Hospital101 avenue Henri Barbusse92140 ClamartFrance Department of Surgery Ecole du Val‑de‑GrâceFrench Military Health Service Academy1place Alphonse Laveran75005 ParisFrance Military Biomedical Research Institute(IRBA) 1 place Général Valérie André91220 Brétigny‑sur‑OrgeFrance

Because of its simplicity,reliability,and replicability,the Masquelet induced membrane technique(IMT)has become one of the preferred methods for critical bone defect reconstruction in *** it is now used worldwide,few studies have been published about IMT in military *** reconstruction is particularly challenging in this context of care due to extensive soft-tissue injury,early wound infection,and even delayed management in austere *** on our clinical expertise,recent research,and a literature analysis,this narrative review provides an overview of the IMT application to combat-related bone *** presents technical specificities and future developments aiming to optimize IMT outcomes,including for the management of massive multi-tissue defects or bone reconstruction performed in the field with limited resources.

关键词： Bone defect Induced membrane technique Gunshot wound low resources Masquelet technique Military War surgery

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Challenges to establishing and maintaining kidney transplantation programs in developing countries:What are the coping strategies?

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World Journal of Methodology 2024年第2期14卷 1-16页

作者： Rabea Ahmed Gadelkareem Amr Mostafa Abdelgawad Nasreldin Mohammed Mohammed Ali Zarzour Mahmoud Khalil Ahmed Reda Hisham Mokhtar Hammouda Department of Urology Assiut Urology and Nephrology HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt

Kidney transplantation(KT)is the optimal form of renal replacement therapy for patients with end-stage renal ***,this health service is not available to all patients,especially in developing *** deceased donor KT programs are mostly absent,and the living donor KT centers are ***-center studies presenting experiences from developing countries usually report a variety of *** review addresses these challenges and the opposing strategies by reviewing the single-center experiences of developing *** financial challenges hamper the infrastructural and material availability,coverage of transplant costs,and qualification of medical *** sociocultural challenges influence organ donation,equity of beneficence,and regular follow-up *** interests and motives for transplantation may result from high medicolegal responsibilities in KT practice,intense potential psychosocial burdens,complex qualification protocols,and low productivity or compensation for KT *** medical literacy about KT advantages is prevalent among clinicians,patients,and the *** inefficient organizational and regulatory oversight is translated into inefficient healthcare systems,absent national KT programs and registries,uncoordinated job descriptions and qualification protocols,uncoordinated on-site investigations with regulatory constraints,and the prevalence of commercial KT *** challenges resulted in noticeable differences between KT services in developed and developing *** coping strategies can be summarized in two main mechanisms:The first mechanism is maximizing the available resources by increasing the rates of living kidney donation,promoting the expertise of medical personnel,reducing material consumption,and supporting the establishment and maintenance of KT *** latter warrants the expansion of the public sector and the elimination of non-ethical KT *** second mechanism is recru

关键词： Challenges Coping strategies Developing countries Kidney transplantation low resources Single-center

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