An Overview of War-Related Thermal Injuries
An Overview of War-Related Thermal Injuries
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DOI：
10.1097/scs.0b013e3181e1e802
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发表时间：
2010-07-01
影响因子：
0.9
通讯作者：
Schulman, Carl I.
中科院分区：
文献类型：
--
作者：
Roeder, Rosiane Alfinito;Schulman, Carl I.
在战争时期，热损伤一直是发病率和死亡率的来源。从历史上看，它们占所有伤害的5%至20%，死亡率约为4%。虽然烧伤患者构成的伤亡人数很少，但他们消耗了不成比例的资源，需要专门的护理。中东目前的冲突报告了类似的热损伤数字，尽管部署前教育有所改善，以减少非战斗相关的烧伤、阻燃军服，以及通常与热损伤增加相关的战争模式的减少。然而，简易爆炸装置和车载简易爆炸装置的使用增加，成为潜在热伤害的新来源。事实上，与爆炸有关的烧伤的负担增加了，其相关的伤害严重程度评分也增加了。与以往冲突中的情况一样，大多数烧伤是手部和头部烧伤。虽然通常不会危及生命，但手部和面部烧伤会导致严重的身体和心理疾病。在这篇文章中，我们将回顾目前可用的关于伊拉克行动和持久自由行动中与战争有关的热损伤的文献。我们将描述烧伤的流行病学，预防和治疗热损伤的战前准备，以及烧伤患者的评估、分类和最终治疗。此外，我们还将讨论相关的生理和心理疾病，最后讨论整形外科医生在烧伤康复和重建中的作用。
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.