97 Burns in the Military Setting- analyzing 12,799 Routine & Combat Cases

Introduction Burns are an important part of military trauma injuries. Studying the epidemiology, due to large morbidity related issues, is important for decision makers. The aim of the study is to review and characterize the burn injuries that occurred in the Israel Defense Forces (IDF) during the years 2008–2016 in training, routine and war. The burn area, degree, setting, unit, etc. will help us characterize the etiology, severity and consequences which is crucial in developing and directing resources to prevention and treatment programs. Methods All burn injuries in 2008–2016 were retrieved (ICD-Z 940–949). Data was collected from the IDF military medical records and included 3 months of follow-up. We retrieved 65,536 medical records, which included follow up of 12,799 soldiers. Special algorithms were specifically designed to retrieve and analyze variables included. Distribution analysis was performed, Parametric Kruskal–Wallis test was used and Chi Square test was used for comparing categorical variables. Results During the years 2008–2016, 65,536 burn related visits were retrieved and 12,799 burn injuries were identified. Gender distribution in figure 1. Gradual decrease in burn injuries was identified (figure 2). Distribution by Setting (figure 3), Commands (figure 4), Etiologies (figure 5), and etiologies within commands (figure 6). Average Total Body Surface Area (TBSA) was 7.524% (figure 7) and also declined over the years (7.7% in 2008 to 7.1% in 2016). Conclusions The decrease in burn rate could be attributed to the increased awareness of soldiers due to the emphasis given to health education and preventive medicine, as well as to improved protection. Scald and flame replaced by chemicals as the leading etiology, It is hypothesized that a small part of chemical burns is a result of self-infliction, which is more prevalent at non-combat units. Average Total Body Surface Area (TBSA) was similar but lower than other studies. The nature and operation mode of the IDF must be kept in mind- a relatively small army composed mainly with obligatory servicemen, there are no dedicated military hospitals, major trauma can be transported directly to the civilian medical system and not appear in the military medical charts. Applicability of Research to Practice This extensive report shows the trends and characteristics of burn injuries in the IDF, allowing for better understanding of these important injuries, and concluding for target health education based on common etiologies and at-risk populations and commands. IDF Commanders should preserve the current burn prevention educational programs, and protection instruments such as uniforms, special gloves and eye protection appliances, since they seem to work, and improvement was observed. Education should also focus on proper handling of various chemicals, and if self-inflicted suspected- psychological intervention should be considered.