Blast-related burns experienced by U.S. Service members in combat can be devastating, are often more severe than burns occurring in civilian settings, and can be the most complex types of injuries to treat. Deployed Service members have twice the risk of suffering a burn injury compared to civilians. Approximately 5-20 percent of combat casualties during Operation Iraqi Freedom and Operation Enduring Freedom sustained severe burns, with improvised explosive devices (IEDs) accounting for as much as 87 percent of all burns. IED-related burns are often at elevated risk of infection because they are contaminated with dirt and debris. Infection control is essential for burn management, especially because the pathogens that Service members are exposed to are increasingly resistant to antibiotics (read more about wound infection after blast injury here). Skin is an essential organ which, once burned, can no longer perform needed barrier and thermoregulatory functions appropriately. Burns cause a severe inflammatory and hypermetabolic state that can lead to multiple organ failure. Immediate evacuation may not always be possible, meaning burn care has to take place in a prolonged field care environment, which presents challenges unique to the military.
Foundational components of each State-of-the-Science Meeting include a comprehensive background literature review to inform the meeting, panel discussions, presentations by researchers in the field, and working groups chaired by expert panelists that assess the state of the science and make recommendations regarding policy and strategy guidance and future research directions.
During this State-of-the-Science meeting, the expert panel identified critical needs for advanced training of medics, accessible and useable data, and improved communication across the burn treatment community. Meeting proceedings, including key findings and recommendations are available from RAND Corporation. Literature reviews and proceedings from previous State-of-the-Science meetings are available through the meeting links on the left sidebar.
Summaries of the Working Group discussions based on these questions are included in the meeting proceedings report published by the RAND Corporation.
The Expert Panel synthesized findings from the literature review, meeting presentations, and Working Group discussions into four key recommendations for research to advance prevention, mitigation, and treatment of blast-related burn injuries:
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