title: An overview of war-related thermal injuries.
abstract: Thermal injuries have always been a source of morbidity and mortality in times of war. Historically, they constitute 5% to 20% of all injuries and approximately 4% mortality. Although burn patients constitute a small number of casualties, they consume a disproportionate amount of resources and require specialized care. The current conflicts in the Middle East report similar numbers for thermal injuries despite improvement in predeployment education to reduce noncombat-related burns, flame retardant military clothing, and decline of war patterns usually associated with increased thermal injuries. However, the increased use of improvised explosive devices and vehicle-borne improvised explosive devices presents a new source of potential thermal injury. Indeed, the burden of explosion-related burns has increased as has its associated Injury Severity Score. As has been the case in previous conflicts, most burns are hand and head burns. Although usually not life threatening, burns to hands and face lead to significant physical and psychologic morbidities. In this paper, we will review the currently available literature on war-related thermal injuries in Operation Iraqi and Operation Enduring Freedom. We will describe the epidemiology of burn injuries, prewar preparation to prevent and treat thermal injuries, and the assessment, triage, and final treatment of burn patients. In addition, we will discuss the associated physical and psychologic morbidities and, finally, the role of plastic surgeon in burn rehabilitation and reconstruction.
authors.affiliation: Jackson Memorial Hospital; Division of Plastic and Reconstructive Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida. rroeder@med.miami.edu
authors.forename: Rosiane Alfinito
authors.initials: RA
authors.lastname: Roeder
authors.forename: Carl I
authors.initials: CI
authors.lastname: Schulman
mesh_terms: D001458:Bandages; D002056:Burns / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D003646:Debridement; D006801:Humans; D015601:Injury Severity Score; D008887:Military Medicine / Q000379:methods*; D008889:Military Personnel; D014218:Triage; D014481:United States; D014857:Warfare