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Impact of Explosive Devices in Modern Armed Conflicts: In-Depth Analysis of Dutch Battle Casualties in Southern Afghanistan

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Abstract

Background

The patterns and mechanisms of injuries of all Dutch battle casualties (BCs) were analyzed to improve the care for injured service members. We performed an in-depth analysis of all Dutch BCs during the participation of The Netherlands as lead nation in the International Security Assistance Force mission in southern Afghanistan.

Methods

Participants were selected from the trauma registry at the Dutch Role 2 Medical Treatment Facility if they met the criteria for Dutch BC between August 2006 and August 2010.

Results

The trauma registry query resulted in 199 Dutch BCs. The battle injuries were predominantly caused by explosions (83.9 %). The case-fatality rate was 9.5 %: 16.5 % were killed in action, and 1.1 % died of wounds. The wounding pattern was as follows: head and neck (32.2 %), thorax (7.8 %), abdomen (12.7 %), upper extremity (17.6 %), lower extremity (29.7 %). The mean Abbreviated Injury Scale and Injury Severity Score were 3 (range 0–5) and 11 (range 1–43), respectively in the wounded-in-action group.

Conclusions

Explosive devices accounted for almost 85 % of the casualties—much higher than in previous wars. Knowledge of the management of these injuries is also valuable in treating casualties from natural disasters or (terrorist) mass casualty situations. An integral multinational joint approach is highly recommended to develop more effective protective equipment and body armor. Prospective registration in a standardized system of data collection that encompasses all echelons of the medical support organization should be implemented.

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Acknowledgments

The authors thank the Ministry of Defense for approving this protocol. In particular, we wish to thank LCOL D. N. Baalbergen for logistical assistance, and J. M. Snijders and E. J. L. Kerkhoven for assistance in collecting the epidemiologic statistics. Lastly, we thank V. L. I. J. van der Kruit for editorial assistance.

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Department of Surgery, K6-50, Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands

    Rigo Hoencamp & Jaap F. Hamming

  2. Department of Surgery, University Medical Centre, Utrecht, The Netherlands

    Eelco P. Huizinga, Thijs T. C. F. van Dongen & Luke P. H. Leenen

  3. Department of Surgery, Medical Centre Haaglanden, The Hague, The Netherlands

    Floris J. Idenburg

  4. Royal British Legion Centre for Blast Injury Studies, Imperial College, London, UK

    Arul Ramasamy

Authors
  1. Rigo Hoencamp
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  2. Eelco P. Huizinga
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  3. Thijs T. C. F. van Dongen
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  4. Floris J. Idenburg
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  5. Arul Ramasamy
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  6. Luke P. H. Leenen
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  7. Jaap F. Hamming
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Corresponding author

Correspondence to Rigo Hoencamp.

Additional information

Rigo Hoencamp and Eelco P. Huizinga have contributed equally to this manuscript (shared first author)

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Hoencamp, R., Huizinga, E.P., van Dongen, T.T.C.F. et al. Impact of Explosive Devices in Modern Armed Conflicts: In-Depth Analysis of Dutch Battle Casualties in Southern Afghanistan. World J Surg 38, 2551–2557 (2014). https://doi.org/10.1007/s00268-014-2645-5

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