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Tue Mar 20 04:38:32 GMT 2007

I was just at a AAST USUHS sponsored symposium at USUHS.   The  subject was 
"Damage Control" Data Driven analysis and development of three white  papers.   

Great meeting.   What struck me most was the absolutely fantastic  
effectiveness of temporary abdominal closure (TAC) EDUCATION given to  troops going 
over.   A STANDARD Surgical Best Practice has been  established with an expanded 
indication for temporary abdominal closure to  prevent abdominal compartment 
syndrome, which having an objective of hemorrhage  control.    REMARKABLE 
EFFECTIVE.     Most  TAC was performed in Iraq, and almost 1/2 had definitive 
closure in Germany,  while the rest were sent on to US at Walter Reed.   The 
hemorrhage  control was remarkable effective and done in Iraq.   Only ONE case  
(during the time period of analysis) arrived in Germany and needed to have a TAC  
applied.   I know of NO civilian trauma center that has such an  effective 
training program, effective application of a practice guideline, an  effective 
hemorrhage control, and such a low rate of missed Abd Compartment  Syndrome.  

Hats off (CONGRATULATIONS) to our military medical establishment and their  
focus on quality care, reproducible application of a surgical principle and  
practice guideline,   analysis of best practices,  and an  effective application 
of continuums of care at all levels of the  Echelons.   Let us assure that 
continuing funding for quality patient  care is given to our troops that are 
wounded and support for our military  medical colleagues who put their lives on 
the line to assure the best of the  best cutting edge care is given from injury 
to recovery.  

k

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