Hedman Travis L, Renz Evan M, Richard Reginald L, Quick Charles D, Dewey William S, Barillo David J, Cancio Leopoldo C, Baer David G, Wolf Steven E, Holcomb John B
United States Army Institute of Surgical Research, Burn Center, Fort Sam Houston, TX 78234, USA.
J Trauma. 2008 Feb;64(2 Suppl):S169-72; discussion S172-3. doi: 10.1097/TA.0b013e318160ba0c.
Operations Enduring Freedom and Iraqi Freedom have resulted in severe burns to the hands. Because of the frequency and severity of hand burns, an All Army Activity (ALARACT) message was distributed emphasizing the importance of hand protection (HP). Our purpose was to assess the effectiveness of the ALARACT in reducing the incidence and severity of hand burns.
A retrospective review of the US Army Institute of Surgical Research Burn Registry for active duty personnel with hand burns 17 months before and after the ALARACT was conducted. Data include percentage total body surface area (% TBSA), % full-thickness injury, depth of hand burn, and ratio of hand burn to TBSA. Statistical analysis was performed using Mann-Whitney U test.
Four hundred fifty-one military personnel were admitted during the 34-month period: 257 (56.9%) pre-ALARACT; 194 (43.1%) post-ALARACT. Two hundred thirty-nine (52.9%) sustained hand burns: 138 (53.7%) pre-ALARACT; 101 (52.1%) post-ALARACT (p = NS). Mean TBSA: 21.5% pre-ALARACT; 28.8% post- ALARACT (p = 0.01). Mean full-thickness TBSA: 14.5% pre-ALARACT; 21.9% post-ALARACT (p = 0.02). Mean hand TBSA: 3.2% pre-ALARACT; 3.2% post-ALARACT (p = NS). Mean ratio, hand burn to TBSA: 36% pre-ALARACT; 25% post-ALARACT (p < 0.001).
Post-ALARACT, the incidence of hand burns remained unchanged. Despite an increase in burn severity, ratio of hand burn to TBSA decreased, suggesting a possible relationship between increased awareness and use of HP and decreased injury. Based on the data collected, the impact of the ALARACT is unclear. The importance of HP remains a priority. The fact that the incidence of hand burns remains unchanged demands our continued awareness and increased efforts.
“持久自由行动”和“伊拉克自由行动”导致手部严重烧伤。由于手部烧伤的频率和严重程度，一份全军通告（ALARACT）被发布，强调手部防护（HP）的重要性。我们的目的是评估该全军通告在降低手部烧伤发生率和严重程度方面的有效性。
对美国陆军外科研究所烧伤登记处中在全军通告发布前后17个月内手部烧伤的现役人员进行回顾性研究。数据包括全身表面积百分比（%TBSA）、全层损伤百分比、手部烧伤深度以及手部烧伤与全身表面积的比例。使用曼-惠特尼U检验进行统计分析。
在34个月期间，共有451名军事人员入院：全军通告发布前257人（56.9%）；全军通告发布后194人（43.1%）。239人（52.9%）手部烧伤：全军通告发布前138人（53.7%）；全军通告发布后101人（52.1%）（p = 无显著差异）。平均全身表面积百分比：全军通告发布前为21.5%；全军通告发布后为28.8%（p = 0.01）。平均全层全身表面积百分比：全军通告发布前为14.5%；全军通告发布后为21.9%（p = 0.02）。平均手部全身表面积百分比：全军通告发布前为3.2%；全军通告发布后为3.2%（p = 无显著差异）。手部烧伤与全身表面积的平均比例：全军通告发布前为36%；全军通告发布后为25%（p < 0.001）。
全军通告发布后，手部烧伤的发生率保持不变。尽管烧伤严重程度有所增加，但手部烧伤与全身表面积的比例下降，这表明手部防护意识和使用的增加与损伤减少之间可能存在关联。根据收集到的数据，全军通告的影响尚不清楚。手部防护的重要性仍然是一个优先事项。手部烧伤发生率保持不变这一事实要求我们持续保持警惕并加大努力。
