ABSTRACT

Aim of the review

This review aims to describe the current state of regenerative rehabilitation of severe military extremity injuries, and promising new therapies on the horizon.

Discussion

The nature of warfare is rapidly shifting with information operations, autonomous weapons, and the threat of full-scale peer adversary conflicts threatening to create contested environments with delayed medical evacuation to definitive care. More destructive weapons will lead to more devastating injuries, creating new challenges for limb repair and restoration. Current paradigms of delayed rehabilitation following initial stabilization, damage control surgery, and prolonged antibiotic therapy will need to shift. Advances in regenerative medicine technologies offer the possibility of treatment along the continuum of care. Regenerative rehabilitation will begin at the point of injury and require a holistic, organ-systems approach.

Conclusions

Both technological improvements and a rapidly advancing understanding of injury pathophysiology will contribute to improved limb-salvage outcomes, and shift the calculus away from early limb amputation.

中文翻译：

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军事冲突中灾难性肢体损伤的再生康复和最近发展努力的回顾。

摘要

审查的目的

本综述旨在描述严重军事肢体损伤再生康复的现状，以及即将出现的有希望的新疗法。

讨论

战争的性质正在随着信息作战、自主武器以及全面对等对手冲突的威胁而迅速转变，这些威胁可能会造成有争议的环境，医疗后送延迟到最终护理。更具破坏性的武器将导致更具破坏性的伤害，为肢体修复和恢复带来新的挑战。当前在初始稳定、损伤控制手术和延长抗生素治疗后延迟康复的范式需要改变。再生医学技术的进步提供了在连续护理过程中进行治疗的可能性。再生康复将从受伤点开始，需要一个整体的器官系统方法。

结论

技术进步和对损伤病理生理学的快速理解都将有助于改善保肢结果，并使早期截肢远离微积分。