Explosive Weapons Trauma Care Collective (EXTRACCT) Blast Injury Clinical Practice Guideline: Genito-Urinary Trauma

Area of Science:

• Trauma Surgery
• Urology
• Blast Injury Management

Background:

• Explosive weapons, including landmines and improvised explosive devices, cause significant urogenital injuries.
• These injuries disproportionately affect lower- and middle-income regions.
• Current best practices for managing blast-related urogenital trauma are synthesized.

Purpose of the Study:

• To provide a clinical practice guideline for the management of urogenital injury following explosive weapon trauma.
• To offer guidance on assessment, resuscitation, and definitive management strategies.
• To describe essential imaging and surgical techniques for surgeons managing urogenital trauma.

Main Methods:

• An expert literature review of current practices was conducted.
• The review focused on established and emerging management protocols for urogenital blast injuries.

Main Results:

• The guideline outlines a tiered approach to management based on injury severity for both internal urological organs and external genitalia.
• Specific imaging modalities and surgical interventions are detailed.
• Guidance is provided for surgeons with limited experience in urogenital trauma.

Conclusions:

• Urogenital trauma from explosions, while rarely fatal alone, can lead to severe morbidity and mortality when combined with other injuries.
• Effective management strategies are crucial, particularly in resource-constrained environments.
• Adherence to best practice guidelines is essential for improving patient outcomes.