Incidence and Severity of Combat Hand Burns After All Army Activity Message

Operations Enduring Freedom and Iraqi Freedom have resulted in severe burns to the hands. Because of the frequency and severity of hand burns, an All Army Activity (ALARACT) message was distributed emphasizing the importance of hand protection (HP). Our purpose was to assess the effectiveness of the...

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Bibliographic Details
Main Authors: Hedman, Travis L, Renz, Evan M, Richard, Reginald L, Quick, Charles D, Dewey, William S, Barillo, David J, Cancio, Leopoldo C, Baer, David G, Wolf, Steven E, Holcomb, John B
Format: Report
Language:English
Subjects:
BATTLEFIELDS
BURNS(INJURIES)
COMBAT CASUALTIES
FIRE PROTECTIVE CLOTHING
HAND BURNS
HAND PROTECTION
HANDS
Medicine and Medical Research
Protective Equipment
STATISTICAL ANALYSIS
SYMPOSIA
Weapons Effects(biological)
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Summary:Operations Enduring Freedom and Iraqi Freedom have resulted in severe burns to the hands. Because of the frequency and severity of hand burns, an All Army Activity (ALARACT) message was distributed emphasizing the importance of hand protection (HP). Our purpose was to assess the effectiveness of the ALARACT in reducing the incidence and severity of hand burns. A retrospective review of the US Army Institute of Surgical Research Burn Registry for active duty personnel with hand burns 17 months before and after the ALARACT was conducted. Data include percentage total body surface area (% TBSA), % full-thickness injury, depth of hand burn, and ratio of hand burn to TBSA. Statistical analysis was performed using Mann-Whitney U test. Results: Four hundred fifty-one military personnel were admitted during the 34- month period: 257 (56.9%) pre-ALARACT; 194 (43.1%) post-ALARACT. Two hundred thirty-nine (52.9%) sustained hand burns: 138 (53.7%) pre-ALARACT; 101 (52.1%) post-ALARACT (p NS). Mean TBSA: 21.5% pre-ALARACT; 28.8% post- ALARACT (p = 0.01). Mean full-thickness TBSA: 14.5% pre-ALARACT; 21.9% post- ALARACT (p = 0.02). Mean hand TBSA: 3.2% pre-ALARACT; 3.2% post-ALARACT (p = NS). Mean ratio, hand burn to TBSA: 36% pre-ALARACT; 25% post-ALARACT (p 0.001). Post-ALARACT, the incidence of hand burns remained unchanged. Despite an increase in burn severity, ratio of hand burn to TBSA decreased, suggesting a possible relationship between increased awareness and use of HP and decreased injury. Based on the data collected, the impact of the ALARACT is unclear. The importance of HP remains a priority. The fact that the incidence of hand burns remains unchanged demands our continued awareness and increased efforts. Presented at the Advanced Technology Applications for Combat Casualty Care Conference, ATACC 2007, at St. Pete Beach, FL on 13-14 Aug 2007. Published in The Journal of Trauma, Injury, Infection, and Critical Care, v64, n2, S169-S173, Feb Supplement 2008.