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Blast injury from explosive munitions.

I Cernak1, J Savic, D Ignjatovic

  • 1Military Medical Academy, Belgrade, Yugoslavia. Ibolja.Cernak@jcu.edu.au

The Journal of Trauma
|July 27, 1999
PubMed
Summary
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Blast injuries from explosive munitions are more common in war than previously believed, often leading to long-term central nervous system disorders. Eicosanoid changes may help diagnose and monitor blast trauma effects.

Area of Science:

  • War surgery
  • Trauma medicine
  • Explosive ordnance effects

Background:

  • War injuries frequently involve explosive munitions, necessitating a deeper understanding of blast effects.
  • Primary blast injury is often underdiagnosed in the context of extremity wounds.

Purpose of the Study:

  • To evaluate the incidence and consequences of primary blast injury in patients with extremity wounds from explosive munitions.
  • To investigate the association between blast injury and long-term neurological deficits.

Main Methods:

  • A cohort of 1,303 patients with extremity wounds from explosive munitions was analyzed.
  • Patients were categorized into primary blast injury (665) and non-blast injury (658) groups based on clinical presentation.
  • Biochemical markers (eicosanoids) and long-term neurological outcomes were assessed.

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Main Results:

  • Elevated thromboxane A2, prostacyclin, and leukotrienes were observed in the blast injury group.
  • Injury severity scores were comparable between blast and non-blast groups, indicating blast effects beyond physical trauma.
  • 30% of blast injury patients experienced long-term central nervous system disorders, compared to 4% in the non-blast group.

Conclusions:

  • Primary blast injury is a significant and often overlooked component of war-related extremity trauma.
  • Blast injury induces significant physiological stress, evidenced by eicosanoid changes.
  • Long-term neurological sequelae suggest blast injury may contribute to conditions like posttraumatic stress disorder.