Page 9 - Journal of Special Operations Medicine - Spring 2014

Experience in Treating Combat Burns
in Afghanistan by Using Silver-Nylon Dressing

Moreno Pozza, PhD; Pflipsen Matthew, MD; Federico Lunardi, MD

ABSTRACT
Background: On the battlefield, insidious and devastat- bodies over long distances (inducing secondary fall in-
ing weapons like the improvised explosive device (IED) juries), and deliver shrapnel over hundreds of meters.
rapidly emit extreme heat (thousands of degrees), cre- Often, Soldiers are in their vehicles when they hit an
ate a shock wave (overpressure) that can hurl bodies IED and subsequently undergo a more violent exposure
long distances (inducing secondary fall lesions), and to the thermal effects of the blast. Frequently, these
1–3
deliver thousands of pieces of shrapnel over hundreds patients have extensive burn areas, multiple bone frac-
of meters. Materials and Methods: Very often, Soldiers tures, and internal organ lesions.
4,5
injured by an IED blast are inside their vehicle. Subse-
quently, they are exposed to the thermal effects of the It is imperative to treat the burn patient with easy-to-
blast. Frequently, these patients have complex wounds use and effective products that can be used by nonex-
that consist of extensive burn areas, bone fractures, perienced personnel in the wartime setting. Severe burn
and internal organ lesions. The use of silver-nylon burn patients must then be moved as quickly as possible to a
wrap dressing is widely documented for its bactericidal burn unit.
6–8
properties. Silverlon Burn Dressings is an elastic ban-
®
dage made of nylon and plated with pure metallic sil-
ver. Results: In summer 2008, in a U.S. advanced Role Case Presentations
2 facility, two U.S. Soldiers with extensive second- and Two U.S. Soldiers received treatment for extensive burn
third-degree burn injuries were successfully treated with injuries during summer 2008 at a U.S. Role 2 facility (For-
the use of Silverlon Burn Dressings and Silverlon Burn ward Advanced Surgical Team). During an International
®
Gloves. Conclusions: From this experience emerged the Security Assistance Force (ISAF) mission in southwest
ease of use silver-nylon dressing in treating badly burned Afghanistan, the Soldiers patrolled their area inside a
Soldiers on the battlefield. high mobility multipurpose wheeled vehicle (HMMWV)
when they hit an IED. At the time of the blast, the two
Keywords: silver-nylon dressing, combat burns, emergency, Soldiers were wearing the personnel armor system for
burn treatment ground troops, interceptor body armor (IBA), and ad-
vanced combat helmet. Both patients were rapidly evacu-
ated from the blast site and transported via helicopter to
the nearby advanced medical camp. They sustained burns
Introduction
involving the limbs and face, while all other body parts
During the past several decades, there has been a radi- were protected by the helmet and body armor.
cal change in conflicts from symmetric warfare to asym-
metric warfare. These changes have modified military Case One
doctrine, altered demands on logistics, and created new A 20-year-old white man sustained second- and third-
medical protocols. In asymmetric warfare, we have seen degree burns on 63% of his total body surface area
the dispersal of insidious and devastating weapons such (TBSA). The third-degree burns were to the upper limbs,
as the improvised explosive device (IED), vehicle-borne and the second-degree burns were to the lower limbs
IED (VBIED), and suicide vest bombers. and face. His nose hairs were burnt, indicating a burn in
the upper respiratory airways. The upper limbs showed
These weapons have devastating effects on the human a circulation stasis with no radial pulse at the extremity.
body. They rapidly emit intense heat (thousands of de- The lower limbs presented with numerous broken blis-
grees), create shock waves (overpressure) that can hurl ters and skin redness.

1