Effectiveness of the combat pelvic protection system in the prevention of genital and urinary tract injuries: An observational study

John S. Oh, Nhan V. Do, Mary Clouser, Michael Galarneau, Jennifer Philips, Adrian Katschke, Jon Clasper, Eric J. Kuncir

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

BACKGROUND: Historically, the incidence of genital and urinary tract (GU) injuries in major conflicts has been approximately 5%. To mitigate the risk of blast injury to the external genitalia, the United States and United Kingdom issued protective overgarments and undergarments to troops deployed in support of Operation Enduring Freedom. These two systems combined constitute the pelvic protection system (PPS). Our hypothesis was that PPS use is associated with a reduction of GU injuries in subjects exposed to dismounted improvised explosive device blast injuries. METHODS: We identified two groups for comparison: those who were confirmed to have worn the PPS at time of injury (n = 58) and a historical control group who were confirmed as not wearing the PPS (non-PPS) (n = 61). Patients with any level of lower extremity amputation from dismounted improvised explosive device blast mechanism were included. The primary outcome measure was presence of a GU injury on admission. A univariate analysis assessing the strength of association with odds ratios and 95% confidence intervals was performed between the PPS and non-PPS groups. RESULTS: Mean Injury Severity Score (ISS) was higher in the PPS versus the non-PPS group (26.1 vs. 19.3, p = 0.0012). Overall, 31% of the patients in the PPS group sustained at least one GU injury versus 62.3% in the non-PPS group. The odds ratio of sustaining a GU injury in the PPS group as compared with the PPS group is 0.28 (31% vs. 62.3%; 95 % confidence interval, 0.62-0.12; p < 0.001). The most frequent injures were open scrotal/testes wounds, followed by open penis, and open bladder/urethra injuries. CONCLUSION: The use of the PPS is associated with a decreased odds ratio of GU injury. Despite a 31% absolute reduction, future work should focus on improved efficiency. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level IV; therapeutic study, level V.

Original languageEnglish (US)
Pages (from-to)S193-S196
JournalJournal of Trauma and Acute Care Surgery
Volume79
Issue number4
DOIs
StatePublished - Jan 1 2015

Fingerprint

Urinary Tract
Observational Studies
Wounds and Injuries
Blast Injuries
Odds Ratio
Afghan Campaign 2001-
Confidence Intervals
Equipment and Supplies
Injury Severity Score
Genitalia
Penis
Urethra
Amputation
Testis
Epidemiologic Studies
Lower Extremity
Urinary Bladder
Outcome Assessment (Health Care)
Control Groups
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Oh, John S. ; Do, Nhan V. ; Clouser, Mary ; Galarneau, Michael ; Philips, Jennifer ; Katschke, Adrian ; Clasper, Jon ; Kuncir, Eric J. / Effectiveness of the combat pelvic protection system in the prevention of genital and urinary tract injuries : An observational study. In: Journal of Trauma and Acute Care Surgery. 2015 ; Vol. 79, No. 4. pp. S193-S196.
@article{0118357b7b4a463abd4414f24be54aa5,
title = "Effectiveness of the combat pelvic protection system in the prevention of genital and urinary tract injuries: An observational study",
abstract = "BACKGROUND: Historically, the incidence of genital and urinary tract (GU) injuries in major conflicts has been approximately 5{\%}. To mitigate the risk of blast injury to the external genitalia, the United States and United Kingdom issued protective overgarments and undergarments to troops deployed in support of Operation Enduring Freedom. These two systems combined constitute the pelvic protection system (PPS). Our hypothesis was that PPS use is associated with a reduction of GU injuries in subjects exposed to dismounted improvised explosive device blast injuries. METHODS: We identified two groups for comparison: those who were confirmed to have worn the PPS at time of injury (n = 58) and a historical control group who were confirmed as not wearing the PPS (non-PPS) (n = 61). Patients with any level of lower extremity amputation from dismounted improvised explosive device blast mechanism were included. The primary outcome measure was presence of a GU injury on admission. A univariate analysis assessing the strength of association with odds ratios and 95{\%} confidence intervals was performed between the PPS and non-PPS groups. RESULTS: Mean Injury Severity Score (ISS) was higher in the PPS versus the non-PPS group (26.1 vs. 19.3, p = 0.0012). Overall, 31{\%} of the patients in the PPS group sustained at least one GU injury versus 62.3{\%} in the non-PPS group. The odds ratio of sustaining a GU injury in the PPS group as compared with the PPS group is 0.28 (31{\%} vs. 62.3{\%}; 95 {\%} confidence interval, 0.62-0.12; p < 0.001). The most frequent injures were open scrotal/testes wounds, followed by open penis, and open bladder/urethra injuries. CONCLUSION: The use of the PPS is associated with a decreased odds ratio of GU injury. Despite a 31{\%} absolute reduction, future work should focus on improved efficiency. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level IV; therapeutic study, level V.",
author = "Oh, {John S.} and Do, {Nhan V.} and Mary Clouser and Michael Galarneau and Jennifer Philips and Adrian Katschke and Jon Clasper and Kuncir, {Eric J.}",
year = "2015",
month = "1",
day = "1",
doi = "10.1097/TA.0000000000000735",
language = "English (US)",
volume = "79",
pages = "S193--S196",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

Effectiveness of the combat pelvic protection system in the prevention of genital and urinary tract injuries : An observational study. / Oh, John S.; Do, Nhan V.; Clouser, Mary; Galarneau, Michael; Philips, Jennifer; Katschke, Adrian; Clasper, Jon; Kuncir, Eric J.

In: Journal of Trauma and Acute Care Surgery, Vol. 79, No. 4, 01.01.2015, p. S193-S196.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Effectiveness of the combat pelvic protection system in the prevention of genital and urinary tract injuries

T2 - An observational study

AU - Oh, John S.

AU - Do, Nhan V.

AU - Clouser, Mary

AU - Galarneau, Michael

AU - Philips, Jennifer

AU - Katschke, Adrian

AU - Clasper, Jon

AU - Kuncir, Eric J.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - BACKGROUND: Historically, the incidence of genital and urinary tract (GU) injuries in major conflicts has been approximately 5%. To mitigate the risk of blast injury to the external genitalia, the United States and United Kingdom issued protective overgarments and undergarments to troops deployed in support of Operation Enduring Freedom. These two systems combined constitute the pelvic protection system (PPS). Our hypothesis was that PPS use is associated with a reduction of GU injuries in subjects exposed to dismounted improvised explosive device blast injuries. METHODS: We identified two groups for comparison: those who were confirmed to have worn the PPS at time of injury (n = 58) and a historical control group who were confirmed as not wearing the PPS (non-PPS) (n = 61). Patients with any level of lower extremity amputation from dismounted improvised explosive device blast mechanism were included. The primary outcome measure was presence of a GU injury on admission. A univariate analysis assessing the strength of association with odds ratios and 95% confidence intervals was performed between the PPS and non-PPS groups. RESULTS: Mean Injury Severity Score (ISS) was higher in the PPS versus the non-PPS group (26.1 vs. 19.3, p = 0.0012). Overall, 31% of the patients in the PPS group sustained at least one GU injury versus 62.3% in the non-PPS group. The odds ratio of sustaining a GU injury in the PPS group as compared with the PPS group is 0.28 (31% vs. 62.3%; 95 % confidence interval, 0.62-0.12; p < 0.001). The most frequent injures were open scrotal/testes wounds, followed by open penis, and open bladder/urethra injuries. CONCLUSION: The use of the PPS is associated with a decreased odds ratio of GU injury. Despite a 31% absolute reduction, future work should focus on improved efficiency. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level IV; therapeutic study, level V.

AB - BACKGROUND: Historically, the incidence of genital and urinary tract (GU) injuries in major conflicts has been approximately 5%. To mitigate the risk of blast injury to the external genitalia, the United States and United Kingdom issued protective overgarments and undergarments to troops deployed in support of Operation Enduring Freedom. These two systems combined constitute the pelvic protection system (PPS). Our hypothesis was that PPS use is associated with a reduction of GU injuries in subjects exposed to dismounted improvised explosive device blast injuries. METHODS: We identified two groups for comparison: those who were confirmed to have worn the PPS at time of injury (n = 58) and a historical control group who were confirmed as not wearing the PPS (non-PPS) (n = 61). Patients with any level of lower extremity amputation from dismounted improvised explosive device blast mechanism were included. The primary outcome measure was presence of a GU injury on admission. A univariate analysis assessing the strength of association with odds ratios and 95% confidence intervals was performed between the PPS and non-PPS groups. RESULTS: Mean Injury Severity Score (ISS) was higher in the PPS versus the non-PPS group (26.1 vs. 19.3, p = 0.0012). Overall, 31% of the patients in the PPS group sustained at least one GU injury versus 62.3% in the non-PPS group. The odds ratio of sustaining a GU injury in the PPS group as compared with the PPS group is 0.28 (31% vs. 62.3%; 95 % confidence interval, 0.62-0.12; p < 0.001). The most frequent injures were open scrotal/testes wounds, followed by open penis, and open bladder/urethra injuries. CONCLUSION: The use of the PPS is associated with a decreased odds ratio of GU injury. Despite a 31% absolute reduction, future work should focus on improved efficiency. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level IV; therapeutic study, level V.

UR - http://www.scopus.com/inward/record.url?scp=84953345041&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84953345041&partnerID=8YFLogxK

U2 - 10.1097/TA.0000000000000735

DO - 10.1097/TA.0000000000000735

M3 - Review article

C2 - 26406430

AN - SCOPUS:84953345041

VL - 79

SP - S193-S196

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 4

ER -