{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:38:45Z","timestamp":1755225525331,"version":"3.43.0"},"reference-count":5,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J R Army Med Corps"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:p>The current conflict in Afghanistan is characterised by significant injuries resulting from the use of Improvised Explosive Devices. Increasing survivability from battlefield injury, escalating musculoskeletal ballistic trauma and the use of blast weaponry combine to produce an injury profile which defines contemporary combat casualty care. Such complex multi-system trauma challenges current wound care rationale. Ballistic injury of the perineum, often associated with proximal femoral injury and significant tissue loss, raises particular management difficulties. These cases demand an individualised, flexible approach due both to the extent of their wounds, logistical issues with positioning and often limited surgical approaches. Routine positioning and approaches around the pelvis may not be available to the surgical team due to presence of external fixators and tenuous skin bridges. The availability of donor skin to cover soft tissue defects is limited and as such, approaches to wounds with minimal additional tissue trauma are of particular use. We describe the benefits of endoscopic techniques and equipment in the evaluation and management of such an injury.<\/jats:p>","DOI":"10.1136\/jramc-157-04-11","type":"journal-article","created":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T19:43:32Z","timestamp":1363722212000},"page":"399-401","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic Evaluation of a Complex Ballistic Injury"],"prefix":"10.1136","volume":"157","author":[{"given":"Will","family":"Eardley","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma, The James Cook University Hospital, Middlesbrough TS4 3BW 0044 1642 850850 willeardley@doctors.org.uk"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Beaven","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Trauma, Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Sargeant","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Trauma, Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2011,12,1]]},"reference":[{"issue":"5","key":"ref_1","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/SAP.0b013e3181bc327a","article-title":"Achieving growth and excellence in medicine: the case history of armed conflict and modern reconstructive surgery","volume":"63","author":"Chambers, J.A.; Ray, P.D.","year":"2009","unstructured":"Chambers JA, Ray PD. Achieving growth and excellence in medicine: the case history of armed conflict and modern reconstructive surgery. Ann Plast Surg 2009; 63(5):473-478.","journal-title":"Ann Plast Surg"},{"issue":"10","key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5435\/00124635-200600001-00002","article-title":"Extremity injury in war: a brief history","volume":"14","author":"Noe, A.","year":"2006","unstructured":"Noe A. Extremity injury in war: a brief history. J Am Acad Orthop Surg 2006; 14(10 Suppl):S1-6.","journal-title":"J Am Acad Orthop Surg"},{"issue":"1","key":"ref_3","doi-asserted-by":"crossref","first-page":"176","DOI":"10.2106\/00004623-200401000-00028","article-title":"Orthopaedic surgery advances resulting from World War II","volume":"86","author":"Dougherty, P.J.; Carter, P.R.; Seligson, D.; Benson, D.R.; Purvis, J.M.","year":"2004","unstructured":"Dougherty PJ, Carter PR, Seligson D, Benson DR, Purvis JM. Orthopaedic surgery advances resulting from World War II. J Bone Joint Surg Am 2004; 86-A(1):176-181.","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"ref_4","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1097\/BOT.0b013e31802f78fb","article-title":"Characterization of extremity wounds in Operation Iraqi Freedom and Operation Enduring Freedom","volume":"21","author":"Owens, B.D.; Kragh, Jr, J.F.; Macaitis, J.; Svoboda, S.J.; Wenke, J.C.","year":"2007","unstructured":"Owens BD, Kragh JF,Jr, Macaitis J, Svoboda SJ, Wenke JC. Characterization of extremity wounds in Operation Iraqi Freedom and Operation Enduring Freedom. J Orthop Trauma 2007; 21(4):254-257.","journal-title":"J Orthop Trauma"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5435\/00124635-201102001-00002","article-title":"Battlefield Orthopaedic Injuries Cause the Majority of Long-term Disabilities","volume":"19","year":"2011","unstructured":"Cross JD, Ficke JR, Hsu JR, Masini BD, Wenke JC. Battlefield Orthopaedic Injuries Cause the Majority of Long-term Disabilities. J Am Acad Orthop Surg 2011; 19(Suppl 1):S1-7.","journal-title":"J Am Acad Orthop Surg"}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-157-04-11","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T14:16:43Z","timestamp":1755094603000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-157-04-11"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12]]},"references-count":5,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2011,12,1]]},"published-print":{"date-parts":[[2011,12]]}},"alternative-id":["10.1136\/jramc-157-04-11"],"URL":"https:\/\/doi.org\/10.1136\/jramc-157-04-11","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"type":"print","value":"0035-8665"},{"type":"electronic","value":"2052-0468"}],"subject":[],"published":{"date-parts":[[2011,12]]}}}