Defining the essential anatomical coverage provided by military body armour against high energy projectiles.
BACKGROUND
Body armour is a type of equipment worn by military personnel that aims to prevent or reduce the damage caused by ballistic projectiles to structures within the thorax and abdomen. Such injuries remain the leading cause of potentially survivable deaths on the modern battlefield. Recent developments in computer modelling in conjunction with a programme to procure the next generation of UK military body armour has provided the impetus to re-evaluate the optimal anatomical coverage provided by military body armour against high energy projectiles.


METHODS
A systematic review of the literature was undertaken to identify those anatomical structures within the thorax and abdomen that if damaged were highly likely to result in death or significant long-term morbidity. These structures were superimposed upon two designs of ceramic plate used within representative body armour systems using a computerised representation of human anatomy.


CONCLUSIONS
Those structures requiring essential medical coverage by a plate were demonstrated to be the heart, great vessels, liver and spleen. For the 50th centile male anthropometric model used in this study, the front and rear plates from the Enhanced Combat Body Armour system only provide limited coverage, but do fulfil their original requirement. The plates from the current Mark 4a OSPREY system cover all of the structures identified in this study as requiring coverage except for the abdominal sections of the aorta and inferior vena cava. Further work on sizing of plates is recommended due to its potential to optimise essential medical coverage.
Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK Biomedical Sciences Department, Dstl Porton Down, Salisbury, Wiltshire, UK.
John
J
Breeze
Defence Equipment and Support, Ministry of Defence Abbey Wood, Bristol, UK.
E A
EA
Lewis
Land Battlespace Systems Department, Defence Science & Technology Laboratory, Fareham, Hampshire, UK.
R
R
Fryer
Biomedical Sciences Department, Dstl Porton Down, Salisbury, Wiltshire, UK.
A E
AE
Hepper
Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK.
Peter F
PF
Mahoney
The Royal British Legion Centre for Blast Injury Studies at Imperial College London, London, UK.
Jon C
JC
Clasper
D000007:Abdominal Injuries / Q000517:prevention & control*; D001011:Aorta / Q000033:anatomy & histology / Q000293:injuries; D004867:Equipment Design; D006321:Heart / Q000033:anatomy & histology; D006335:Heart Injuries / Q000517:prevention & control; D006801:Humans; D008099:Liver / Q000033:anatomy & histology / Q000293:injuries; D008889:Military Personnel; D011481:Protective Clothing; D013154:Spleen / Q000033:anatomy & histology / Q000293:injuries; D013898:Thoracic Injuries / Q000517:prevention & control*; D014948:Wounds, Gunshot / Q000517:prevention & control*; D014950:Wounds, Penetrating / Q000517:prevention & control
FORENSIC MEDICINE; TRAUMA MANAGEMENT