Incidence and severity of combat hand burns after All Army Activity message.

Travis L. Hedman, Evan M. Renz, Reginald L. Richard, Charles D. Quick, William S. Dewey, David J. Barillo, Leopoldo C. Cancio, David G. Baer, Steven E. Wolf, John B. Holcomb

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

BACKGROUND: Operations Enduring Freedom and Iraqi Freedom have resulted in severe burns to the hands. Because of the frequency and severity of hand burns, an All Army Activity (ALARACT) message was distributed emphasizing the importance of hand protection (HP). Our purpose was to assess the effectiveness of the ALARACT in reducing the incidence and severity of hand burns. METHODS: A retrospective review of the US Army Institute of Surgical Research Burn Registry for active duty personnel with hand burns 17 months before and after the ALARACT was conducted. Data include percentage total body surface area (% TBSA), % full-thickness injury, depth of hand burn, and ratio of hand burn to TBSA. Statistical analysis was performed using Mann-Whitney U test. RESULTS: Four hundred fifty-one military personnel were admitted during the 34-month period: 257 (56.9%) pre-ALARACT; 194 (43.1%) post-ALARACT. Two hundred thirty-nine (52.9%) sustained hand burns: 138 (53.7%) pre-ALARACT; 101 (52.1%) post-ALARACT (p = NS). Mean TBSA: 21.5% pre-ALARACT; 28.8% post- ALARACT (p = 0.01). Mean full-thickness TBSA: 14.5% pre-ALARACT; 21.9% post-ALARACT (p = 0.02). Mean hand TBSA: 3.2% pre-ALARACT; 3.2% post-ALARACT (p = NS). Mean ratio, hand burn to TBSA: 36% pre-ALARACT; 25% post-ALARACT (p < 0.001). DISCUSSION: Post-ALARACT, the incidence of hand burns remained unchanged. Despite an increase in burn severity, ratio of hand burn to TBSA decreased, suggesting a possible relationship between increased awareness and use of HP and decreased injury. Based on the data collected, the impact of the ALARACT is unclear. The importance of HP remains a priority. The fact that the incidence of hand burns remains unchanged demands our continued awareness and increased efforts.

Original languageEnglish (US)
JournalThe Journal of trauma
Volume64
Issue number2 Suppl
StatePublished - Feb 2008

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Burns
Hand
Incidence
Afghan Campaign 2001-
Hand Injuries
Body Surface Area
Military Personnel
Nonparametric Statistics
Registries

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hedman, T. L., Renz, E. M., Richard, R. L., Quick, C. D., Dewey, W. S., Barillo, D. J., ... Holcomb, J. B. (2008). Incidence and severity of combat hand burns after All Army Activity message. The Journal of trauma, 64(2 Suppl).

Incidence and severity of combat hand burns after All Army Activity message. / Hedman, Travis L.; Renz, Evan M.; Richard, Reginald L.; Quick, Charles D.; Dewey, William S.; Barillo, David J.; Cancio, Leopoldo C.; Baer, David G.; Wolf, Steven E.; Holcomb, John B.

In: The Journal of trauma, Vol. 64, No. 2 Suppl, 02.2008.

Research output: Contribution to journalArticle

Hedman, TL, Renz, EM, Richard, RL, Quick, CD, Dewey, WS, Barillo, DJ, Cancio, LC, Baer, DG, Wolf, SE & Holcomb, JB 2008, 'Incidence and severity of combat hand burns after All Army Activity message.', The Journal of trauma, vol. 64, no. 2 Suppl.
Hedman TL, Renz EM, Richard RL, Quick CD, Dewey WS, Barillo DJ et al. Incidence and severity of combat hand burns after All Army Activity message. The Journal of trauma. 2008 Feb;64(2 Suppl).
Hedman, Travis L. ; Renz, Evan M. ; Richard, Reginald L. ; Quick, Charles D. ; Dewey, William S. ; Barillo, David J. ; Cancio, Leopoldo C. ; Baer, David G. ; Wolf, Steven E. ; Holcomb, John B. / Incidence and severity of combat hand burns after All Army Activity message. In: The Journal of trauma. 2008 ; Vol. 64, No. 2 Suppl.
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title = "Incidence and severity of combat hand burns after All Army Activity message.",
abstract = "BACKGROUND: Operations Enduring Freedom and Iraqi Freedom have resulted in severe burns to the hands. Because of the frequency and severity of hand burns, an All Army Activity (ALARACT) message was distributed emphasizing the importance of hand protection (HP). Our purpose was to assess the effectiveness of the ALARACT in reducing the incidence and severity of hand burns. METHODS: A retrospective review of the US Army Institute of Surgical Research Burn Registry for active duty personnel with hand burns 17 months before and after the ALARACT was conducted. Data include percentage total body surface area ({\%} TBSA), {\%} full-thickness injury, depth of hand burn, and ratio of hand burn to TBSA. Statistical analysis was performed using Mann-Whitney U test. RESULTS: Four hundred fifty-one military personnel were admitted during the 34-month period: 257 (56.9{\%}) pre-ALARACT; 194 (43.1{\%}) post-ALARACT. Two hundred thirty-nine (52.9{\%}) sustained hand burns: 138 (53.7{\%}) pre-ALARACT; 101 (52.1{\%}) post-ALARACT (p = NS). Mean TBSA: 21.5{\%} pre-ALARACT; 28.8{\%} post- ALARACT (p = 0.01). Mean full-thickness TBSA: 14.5{\%} pre-ALARACT; 21.9{\%} post-ALARACT (p = 0.02). Mean hand TBSA: 3.2{\%} pre-ALARACT; 3.2{\%} post-ALARACT (p = NS). Mean ratio, hand burn to TBSA: 36{\%} pre-ALARACT; 25{\%} post-ALARACT (p < 0.001). DISCUSSION: Post-ALARACT, the incidence of hand burns remained unchanged. Despite an increase in burn severity, ratio of hand burn to TBSA decreased, suggesting a possible relationship between increased awareness and use of HP and decreased injury. Based on the data collected, the impact of the ALARACT is unclear. The importance of HP remains a priority. The fact that the incidence of hand burns remains unchanged demands our continued awareness and increased efforts.",
author = "Hedman, {Travis L.} and Renz, {Evan M.} and Richard, {Reginald L.} and Quick, {Charles D.} and Dewey, {William S.} and Barillo, {David J.} and Cancio, {Leopoldo C.} and Baer, {David G.} and Wolf, {Steven E.} and Holcomb, {John B.}",
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AU - Hedman, Travis L.

AU - Renz, Evan M.

AU - Richard, Reginald L.

AU - Quick, Charles D.

AU - Dewey, William S.

AU - Barillo, David J.

AU - Cancio, Leopoldo C.

AU - Baer, David G.

AU - Wolf, Steven E.

AU - Holcomb, John B.

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N2 - BACKGROUND: Operations Enduring Freedom and Iraqi Freedom have resulted in severe burns to the hands. Because of the frequency and severity of hand burns, an All Army Activity (ALARACT) message was distributed emphasizing the importance of hand protection (HP). Our purpose was to assess the effectiveness of the ALARACT in reducing the incidence and severity of hand burns. METHODS: A retrospective review of the US Army Institute of Surgical Research Burn Registry for active duty personnel with hand burns 17 months before and after the ALARACT was conducted. Data include percentage total body surface area (% TBSA), % full-thickness injury, depth of hand burn, and ratio of hand burn to TBSA. Statistical analysis was performed using Mann-Whitney U test. RESULTS: Four hundred fifty-one military personnel were admitted during the 34-month period: 257 (56.9%) pre-ALARACT; 194 (43.1%) post-ALARACT. Two hundred thirty-nine (52.9%) sustained hand burns: 138 (53.7%) pre-ALARACT; 101 (52.1%) post-ALARACT (p = NS). Mean TBSA: 21.5% pre-ALARACT; 28.8% post- ALARACT (p = 0.01). Mean full-thickness TBSA: 14.5% pre-ALARACT; 21.9% post-ALARACT (p = 0.02). Mean hand TBSA: 3.2% pre-ALARACT; 3.2% post-ALARACT (p = NS). Mean ratio, hand burn to TBSA: 36% pre-ALARACT; 25% post-ALARACT (p < 0.001). DISCUSSION: Post-ALARACT, the incidence of hand burns remained unchanged. Despite an increase in burn severity, ratio of hand burn to TBSA decreased, suggesting a possible relationship between increased awareness and use of HP and decreased injury. Based on the data collected, the impact of the ALARACT is unclear. The importance of HP remains a priority. The fact that the incidence of hand burns remains unchanged demands our continued awareness and increased efforts.

AB - BACKGROUND: Operations Enduring Freedom and Iraqi Freedom have resulted in severe burns to the hands. Because of the frequency and severity of hand burns, an All Army Activity (ALARACT) message was distributed emphasizing the importance of hand protection (HP). Our purpose was to assess the effectiveness of the ALARACT in reducing the incidence and severity of hand burns. METHODS: A retrospective review of the US Army Institute of Surgical Research Burn Registry for active duty personnel with hand burns 17 months before and after the ALARACT was conducted. Data include percentage total body surface area (% TBSA), % full-thickness injury, depth of hand burn, and ratio of hand burn to TBSA. Statistical analysis was performed using Mann-Whitney U test. RESULTS: Four hundred fifty-one military personnel were admitted during the 34-month period: 257 (56.9%) pre-ALARACT; 194 (43.1%) post-ALARACT. Two hundred thirty-nine (52.9%) sustained hand burns: 138 (53.7%) pre-ALARACT; 101 (52.1%) post-ALARACT (p = NS). Mean TBSA: 21.5% pre-ALARACT; 28.8% post- ALARACT (p = 0.01). Mean full-thickness TBSA: 14.5% pre-ALARACT; 21.9% post-ALARACT (p = 0.02). Mean hand TBSA: 3.2% pre-ALARACT; 3.2% post-ALARACT (p = NS). Mean ratio, hand burn to TBSA: 36% pre-ALARACT; 25% post-ALARACT (p < 0.001). DISCUSSION: Post-ALARACT, the incidence of hand burns remained unchanged. Despite an increase in burn severity, ratio of hand burn to TBSA decreased, suggesting a possible relationship between increased awareness and use of HP and decreased injury. Based on the data collected, the impact of the ALARACT is unclear. The importance of HP remains a priority. The fact that the incidence of hand burns remains unchanged demands our continued awareness and increased efforts.

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