Surgical management of focal ionising radiation burns

Swain, Cara; Khan, Muhammad Idrees

doi:10.1136/jramc-2018-000967

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…This may necessitate deploying specialist surgical teams to these regions. However, prolonged timelines in casualties reaching these teams from the CBRNE 3 environment may result in more morbidity and mortality from these injuries 14…”

Section: Specialist Equipment and Skillsmentioning

confidence: 99%

CBRNE³medicine in the austere environment: the challenges

Smith¹,

Weir

2022

BMJ Mil Health

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Chemical, Biological, Radiological, Nuclear and Explosive/Environmental/Endemic Disease (CBRNE3) incidents encompass a wide spectrum of events from natural events/disasters to industrial accidents through to deliberate military release and nuclear war. The UK military operates globally and in environments that are often austere. The very nature of these environments means that CBRNE3incidents are a very real risk, and a CBRNE3incident in a well-developed society could ultimately create an austere environment. Responding to such an event in an austere environment poses challenges.The very nature of the environment may be problematic. It may be very remote with limited or no access by road and/or air. It may have limited resources such as water and infrastructure required to manage the event. Extremes of temperature and weather may pose a risk to casualties and responders alike. Specialist teams and equipment may be required, but the host or partner nations may not have suitable capability and these resources may take time to mobilise from the home base. The volume of equipment and material needed in the response may overwhelm logistical chains which may not be robust enough to withstand the initial incident.Proper planning and preparedness is crucial to operating in and managing a CBRNE3incident in an austere environment. Recognition of the potential threat by intelligence gathering and recognition by personnel on the ground are essential. This requires an appropriate awareness at all levels of command and appropriate prior training, including interoperability training with partner forces. Ultimately, robust planning and training is key to managing CBRNE3incidents in an austere environment.

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Section: Specialist Equipment and Skillsmentioning

confidence: 99%

CBRNE³medicine in the austere environment: the challenges

Smith¹,

Weir

2022

BMJ Mil Health

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“…The term is used occasionally in the surgical literature, 31 despite the marked differences in the underlying radiation “burns” in comparison to electrical, thermal, and chemical burns. 32,33 Relevant literature describing “radiation burns” includes descriptions of medical countermeasures related to nuclear events, 34 case reports of radiation burns sustained in accidental or workplace exposure, 35 radiation burns resulting from the therapeutic use of ionizing radiation, 36 and radiation burns sustained from fluoroscopy or other radiation-guided medical procedures. 37 Further complicating this term's use in clinical practice is that the International Classification of Diseases, 10th Revision (ICD-10) provides codes for “radiation-related disorders of the skin and subcutaneous tissue”, but not radiation burn.…”

Section: “Radiation Burn”mentioning

confidence: 99%

Review of the Terminology Describing Ionizing Radiation-Induced Skin Injury: A Case for Standardization

Burnett

Hughes

Rejeski

et al. 2021

Technol Cancer Res Treat

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Ionizing radiation causes injury to the skin that produces a complex clinical presentation that is managed by various paradigms without clear standards. The situation is further complicated by the fact that clinicians and researchers often use different terms and billing codes to describe the spectrum of cutaneous injury. There is, however, general agreement between the two most commonly-used diagnostic scales, the Radiation Therapy Oncology Group and the Common Terminology Criteria for Adverse Events, and in their use to describe skin injury following radiation therapy. These scales are typically used by radiation oncologists to quantify radiation dermatitis, a component of the radiation-related disorders of the skin and subcutaneous tissue family of diagnoses. In rare cases, patients with severe injury may require treatment by wound care or burn specialists, in which case the disease is described as a “radiation burn” and coded as a burn or corrosion. Further compounding the issue, most US government agencies use the term Cutaneous Radiation Injury to indicate skin damage resulting from large, whole-body exposures. In contrast, the US Food and Drug Administration approves products for radiation dermatitis or “burns caused by radiation oncology procedures.” A review of the literature and comparison of clinical presentations shows that each of these terms represents a similar injury, and can be used interchangeably. Herein we provide a comparative review of the commonly used terminology for radiation-induced skin injury. Further, we recommend standardization across clinicians, providers, and researchers involved in the diagnosis, care, and investigation of radiation-induced skin injury. This will facilitate collaboration and broader inclusion criteria for grant-research and clinical trials and will assist in assessing therapeutic options particularly relevant to patient skin pigmentation response differences.

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Surgical management of focal ionising radiation burns

Cited by 2 publications

References 12 publications

CBRNE³medicine in the austere environment: the challenges

CBRNE³medicine in the austere environment: the challenges

Review of the Terminology Describing Ionizing Radiation-Induced Skin Injury: A Case for Standardization

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Surgical management of focal ionising radiation burns

Cited by 2 publications

References 12 publications

CBRNE3medicine in the austere environment: the challenges

CBRNE3medicine in the austere environment: the challenges

Review of the Terminology Describing Ionizing Radiation-Induced Skin Injury: A Case for Standardization

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Product

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CBRNE³medicine in the austere environment: the challenges

CBRNE³medicine in the austere environment: the challenges