Blast injury to the perineum

Sharma, Divya; Webster, Claire; Kirkman-Brown, Jackson; Mossadegh, Somayyeh; Whitbread, T.

doi:10.1136/jramc-2013-000024

Cited by 11 publications

(4 citation statements)

References 9 publications

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“…While injuries to ‘desirable structures’ are not responsible for mortality in isolation, for example, the penis, testicles and perineum, there are long-term physiological and psychological consequences of such injuries. For example, while reported injuries to the perineum were rare on combat operations in Afghanistan (5% of all casualties4 and perineal injury is not defined as an essential structure (Table 1); the long-term physiological and psychological consequences of an injury could include sexual and psychosexual dysfunction, urinary storage and voiding dysfunction, urinary and faecal incontinence, loss of fertility, testosterone deficiency and the necessity for complex surgical reconstruction 5…”

Section: Discussionmentioning

confidence: 99%

“…Published medical evidence exists to support which structures are responsible for morbidity 2 4 5 7 10–14. This was subsequently analysed in a multidisciplinary forum of clinicians including specialists in general surgery, orthopaedic surgery and urology to determine what structures should encompass desired coverage (Table 1, Figure 3).…”

Section: Methodsmentioning

confidence: 99%

“…Large vessel injury was present in 44% of casualties with pelvic fractures and was associated with mortality rates as high as 90% in the prehospital setting before reaching surgical care 3. Perineal injury was present in 5% of all casualties4 and resulted in considerable long- term morbidity 5. These included sexual and psychosexual dysfunction, urinary storage and voiding dysfunction, urinary and faecal incontinence, loss of fertility, testosterone deficiency and the necessity for complex surgical reconstruction.…”

Section: Introductionmentioning

confidence: 99%

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Defining the medical coverage of ballistic protection to the pelvis and thigh

2020

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IntroductionPelvis, lower limb and associated genital injury caused by explosive devices was responsible for mortality and considerable long-term morbidity for the UK Armed Forces during combat operations in Afghanistan, resulting in the issue of a pelvic protection system in 2010. The aim of this current research was to determine the medical coverage of the pelvis and thigh and to define the vertical dimensions of ballistic protective material for future pelvic protection (PP).MethodCT scans from 120 male UK Armed Forces personnel were analysed to identify the anthropometric landmarks and vertical boundaries of coverage for the pelvis and thigh. Pelvic height was the vertical distance between the upper border of the iliac crest in the midaxillary plane to the most inferior point of the ischial tuberosity of the pelvis. Upper thigh height was proposed as a 100 mm fixed distance below the ischial tuberosities, enabling a tourniquet to be reproducibly applied. These distances were compared with the ballistic component of the five sizes of tier 1 PP using a paired t-test.ResultsThe vertical components of coverage measured using CT scans were all significantly less (p<0.01) compared with all five sizes of tier 1 PP; for example, the ballistic component of the smallest size of tier 1 PP measured 410 mm, which was larger than the 99th percentile male, which measured 346 mm on CT scans.ConclusionsWhile all sizes of tier 1 PP provide coverage to the pelvis and upper thigh structures, there is an opportunity to optimise future PP. For example, comparing the large size of tier 1 PP to the 50th percentile male demonstrated an opportunity to reduce the ballistic protective component by 31%. Reducing the quantity of material used will improve heat dissipation and user comfort and reduce material mass and acquisition costs.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Defining the medical coverage of ballistic protection to the pelvis and thigh

2020

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“…Genital injuries are common in the post-9/11 generation of combat veterans, largely due to the increased number of patrols conducted on foot and high exposure to explosive devices [36,37]. An estimated 5% to 12% of injuries in the post-9/11 era have involved genital injuries [38,38].…”

Section: Vignette: Mannymentioning

confidence: 99%

Sex and the Military: A model for provider education

Wilcox¹,

Whitsett²,

Finney³

2016

Contemp Behav Health Care

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Military populations have increased exposure to physical and psychological trauma, which increases their vulnerability to sexual dysfunction. Despite high rates of sexual functioning problems in military populations, including erectile dysfunction and anorgasmia, few behavioral health providers are adequately prepared to address these problems, partly due to a lack of training options. The Sex & the Military Toolkit is the first freely available training on sexual dysfunction in military populations that provides preliminary insight on this key issue and is translatable to civilian populations. This manuscript presents an overview of the toolkit with emphasis on the video vignettes (confabulated) and provides clinical considerations, therapy suggestions, and sex-specific intervention strategies.

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Traumatic Scrotal and Testicular Injuries

Hadjipavlou¹,

Sharma²

2021

A Clinical Guide to Urologic Emergencies

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Blast injury to the perineum

Cited by 11 publications

References 9 publications

Defining the medical coverage of ballistic protection to the pelvis and thigh

Defining the medical coverage of ballistic protection to the pelvis and thigh

Sex and the Military: A model for provider education

Traumatic Scrotal and Testicular Injuries

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