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TABLE 1 An Example of a Ruck-Truck-House-Plane Model for Preventing Combat-Related Wound Infections and Spread of Multidrug-
Resistant Organisms (MDROs)
RUCK • Rough debridement, with debris removal.
• Irrigation even with potable water.
• Consider (oral-) antibiotic administration (open fractures, . . .).
• Tourniquet conversion, as early as possible?
TRUCK • Continued wound assessment.
• Tourniquet conversion, as early as possible?
• Consider or continue antibiotic administration (open fractures, . . .).
• Dressing changes.
HOUSE • Clean wounds thoroughly.
• Remove remaining debris.
• Apply sterile dressings.
• Surgical debridement?
• Continue to administer antibiotics.
• Dressing reconditioning.
• Keep wounds moist, protected, and free from friction.
• Support recovery by hydration, nutrition, and proper dressings.
• ± field amputation in (very-) prolonged care?
• Consider reach back (i.e. telemedicine – if operationally possible) to tailor antibiotic regimen to
possible organism and infection.
PLANE, And FURTHER . . . • Microbiological monitoring / remote molecular tools.
• Continue to administer antibiotics.
• Rapid screening and diagnosis of MDRO at infected sites.
• Implementing lab-based surveillance within military health services, as part of a global surveillance
network.

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