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            "title": "Comparison between civilian burns and combat burns from Operation Iraqi Freedom and Operation Enduring Freedom",
            "creators": [
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                    "firstName": "Steven E",
                    "lastName": "Wolf"
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                    "lastName": "Kauvar"
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                    "firstName": "Charles E",
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            "abstractNote": "OBJECTIVE: To assess outcome differences between locally burned civilians and military personnel burned in a distant combat zone treated in the same facility.\nSUMMARY BACKGROUND DATA: The United States Army Institute of Surgical Research (USAISR) Burn Center serves as a referral center for civilians and is the sole center for significant burns in military personnel. We made the hypothesis that outcomes for military personnel burned in the current conflict in Iraq and Afghanistan would be poorer because of delays to definitive treatment, other associated injury, and distance of evacuation.\nMETHODS: We reviewed the civilian and military records of patients treated at the USAISR from the outset of hostilities in Iraq in April 2003 to May 2005. Demographics, injury data, mortality, and clinical outcomes were compared.\nRESULTS: : We cared for 751 patients during this time period, 273 of whom were military (36%). Military injuries occurred in a younger population (41 +/- 19 vs. 26 +/- 7 years for civilian and military respectively, P < 0.0001) with a longer time from injury to burn center arrival (1 +/- 5 days vs. 6 +/- 5, P < 0.0001), a higher Injury Severity Score (ISS 5 +/- 8 vs. 9 +/- 11, P < 0.0001), and a higher incidence of inhalation injury (8% vs. 13%, P = 0.024). Total burn size did not differ. Mortality was 7.1% in the civilian and 3.8% in the military group (P = 0.076). When civilians outside the age range of the military cohort were excluded, civilian mortality was 5.0%, which did not differ from the military group (P = 0.57). Total body surface area (TBSA) burned, age > or =40 years, presence of inhalation injury, and ventilator days were found to be important predictors of mortality by stepwise regression, and were used in a final predictive model with the area under receiver operator characteristic curve of 0.97 for both populations considered together. No significant effect of either group was identified during development.\nCONCLUSIONS: Mortality does not differ between civilians evacuated locally and military personnel injured in distant austere environments treated at the same center.",
            "publicationTitle": "Annals of surgery",
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            "title": "Characterization of craniomaxillofacial battle injuries sustained by United States service members in the current conflicts of Iraq and Afghanistan",
            "creators": [
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                    "creatorType": "author",
                    "firstName": "Timothy A",
                    "lastName": "Lew"
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                {
                    "creatorType": "author",
                    "firstName": "John A",
                    "lastName": "Walker"
                },
                {
                    "creatorType": "author",
                    "firstName": "Joseph C",
                    "lastName": "Wenke"
                },
                {
                    "creatorType": "author",
                    "firstName": "Lorne H",
                    "lastName": "Blackbourne"
                },
                {
                    "creatorType": "author",
                    "firstName": "Robert G",
                    "lastName": "Hale"
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            ],
            "abstractNote": "PURPOSE: To characterize and describe the craniomaxillofacial (CMF) battlefield injuries sustained by US Service Members in Operation Iraqi Freedom and Operation Enduring Freedom.\nPATIENTS AND METHODS: The Joint Theater Trauma Registry was queried from October 19, 2001, to December 11, 2007, for CMF battlefield injuries. The CMF injuries were identified using the \"International Classification of Diseases, Ninth Revision, Clinical Modification\" codes and the data compiled for battlefield injury service members. Nonbattlefield injuries, killed in action, and return to duty cases were excluded.\nRESULTS: CMF battlefield injuries were found in 2,014 of the 7,770 battlefield-injured US service members. In the 2,014 injured service members were 4,783 CMF injuries (2.4 injuries per soldier). The incidence of CMF battlefield injuries by branch of service was Army, 72%; Marines, 24%; Navy, 2%; and Air Force, 1%. The incidence of penetrating soft-tissue injuries and fractures was 58% and 27%, respectively. Of the fractures, 76% were open. The location of the facial fractures was the mandible in 36%, maxilla/zygoma in 19%, nasal in 14%, and orbit in 11%. The remaining 20% were not otherwise specified. The primary mechanism of injury involved explosive devices (84%).\nCONCLUSIONS: Of the injured US service members, 26% had injuries to the CMF region in the Operation Iraqi Freedom/Operation Enduring Freedom conflicts during a 6-year period. Multiple penetrating soft-tissue injuries and fractures caused by explosive devices were frequently seen. Increased survivability because of body armor, advanced battlefield medicine, and the increased use of explosive devices is probably related to the elevated incidence of CMF battlefield injuries. The current use of \"International Classification of Diseases, Ninth Revision, Clinical Modification\" codes with the Joint Theater Trauma Registry failed to characterize the severity of facial wounds.",
            "publicationTitle": "Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons",
            "publisher": "",
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            "date": "Jan 2010",
            "volume": "68",
            "issue": "1",
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            "pages": "3-7",
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            "journalAbbreviation": "J. Oral Maxillofac. Surg.",
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