High risk and low prevalence diseases: Blast injuries

Bukowski, Josh; Nowadly, Craig D.; Schauer, Steven G; Koyfman, Alex; Long, Brit

doi:10.1016/j.ajem.2023.05.003

Cited by 9 publications

(1 citation statement)

References 118 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It should be noted that since February 2022, over the past three years, in the context of the armed conflict on the territory of Ukraine, the hot phase of hostilities has been going on, the victims of which are both military personnel and civilians. At the same time, the number of victims is constantly increasing, and the dominant lesions are blast trauma, which is accompanied by bodily injuries of varying severity, highrisk somatic and mental illnesses [3,28].…”

Section: Discussionmentioning

confidence: 99%

Forensic characteristics of injuries from thermo-baric explosive device

Mykhaylenko,

Mishalov,

Kozlov

et al. 2024

Rep. of Morph.

View full text Add to dashboard Cite

Since the beginning of the Russian Federation's invasion of Ukraine in 2022, explosive trauma has become an extremely urgent problem, as the main source of bodily injury among both the military in the combat zone and the civilian population in cities has been the impact of explosive devices. The aim of the study is the examination of the forensic characteristics of damage to biological objects that were formed from thermal exposure and shock wave as a result of the explosion of a cumulative munition and in the conditions of an experimental explosion model. The objects of the study were the materials of two examinations on the death of Ukrainian soldiers who died in the war zone (archival "Conclusions of the medical examination" of the Kyiv City Clinical Bureau of Forensic Medical Examination in 2023). Under the conditions of the experiment, studies of pathomorphological changes in the liver and small intestine of 30 white outbred rats from the action of an artificially created air shock wave with an overpressure of 31.62±4.84 kPa were carried out. The injuries were examined macroscopically and using standard laboratory histological techniques. Microscopy of histological sections was performed using an Axio Imager 2 microscope (Zeiss, Germany) at magnifications of ×200 and ×400. Statistical processing of the obtained quantitative results was carried out using the STATISTICA 6.1 software product. Under the condition of the explosion of the ammunition with the cumulative effect of the rocket-propelled infantry flamethrower "Bumblebee" on sectional incisions of the skin and muscles of the thigh in the projection of areas of redness, a picture of a gelatinous consistency of bright red color was macroscopically determined due to abundant blood impregnation of muscles and subcutaneous fat and partial loss of muscle structure with the release of myoglobin. The bright red color of the skin of the thigh and pelvis without burning the hair may indicate the superficial thermal effect of the explosive device and the protection of the skin by clothing. Diffusely located numerous both paired and single abrasions and shallow wounds, small rounded, oblong, circular in shape, which are the result of fragments of a rocket-propelled grenade equipped with a fire mixture, were also determined. The effect of an air shock wave with an overpressure of 31.62±4.84 kPa on the liver parenchyma of rats was determined by focal hemorrhages with rupture of the terminal central vein of the hepatic lobule, edema of the parasinusoidal spaces, and sludges in the sinusoids. In the wall of the small intestine, acute hemodynamic disorders occurred in the form of vasodilation of arterial vessels, venular and capillary stasis. There was layering and swelling of the small intestine wall, rupture of veins, focal hemorrhage. Thus, the revealed characteristic pathomorphological signs of the destructive effect of overpressure as a result of a blast wave (barotrauma) are typical and common both in the areas of the human thigh and pelvis, and in biological objects of experimental animals. The obtained results are consistent with the pathomorphological manifestations of barotrauma in areas of the human body as a result of the action of an explosive device with a cumulative effect.

show abstract

Section: Discussionmentioning

confidence: 99%