The changing paradigm of injuries and their outcome in an international conflict zone

Abstract

Background: The characteristics of combat injuries differ from those encountered in civilian practice in terms of epidemiology, mechanism of wounding, pathophysiology, trajectory after injury and outcome. Furthermore, the nature of combat injuries is likely to change because of changes in the ways wars will be fought; such changes may influence therapeutic tactics and techniques, and military medical planning and logistics. Proper medical deployment at various peacekeeping missions requires projecting injuries. For this reason, the injury patterns and mechanism of injury were reviewed over a five year period, and injury rates and mechanisms were extracted for review. Methods: An observational study of 2942 trauma cases attending trauma Out Patient Department and emergency centre of United Nations Peacekeeping Mission Hospital in eastern DRC (Democratic Republic of Congo), was carried out from Jan 2009 to Dec 2013. The study includes age profile of patients along with the distribution and mechanism of injuries. Results: Penetrating injuries and blunt injuries accounted for 4.65% and 95.35% respectively of the total injuries sustained. The majority of the patients sustained injuries like mixed burns and inhalation injuries, assaults and contusions (84.33%). The most common age group affected was 22- 29 years (60.74%). Conclusions: The data clearly demonstrate that humanitarian and peacekeeping missions require preparation for a wide variety of mechanisms of injuries including non-combat trauma beyond the expected penetrating missile and blast injuries of a typical war scenario.