Infectious risk for suicide bomber attack victims: management of penetrative wounds in French Army personnel

International Orthopaedics
Nicolas de l'EscalopierSylvain Rigal

Abstract

In suicide bomber attacks (SBAs), the explosive forces may disperse fragments from the body of the bomber to which the device is attached. This biologic material can cause physical injury to bystanders and may represent a source of severe infectious diseases. Two French soldiers, victims of an SBA in Africa, were managed in the Percy Military Teaching Hospital. They sustained multiple injuries, including some caused by bony fragments converted into projectiles by the explosion. One patient had multiple superficial wounds managed conservatively. The other was treated surgically by serial debridement with removal of a bony piece related to the suicide bomber. The decision not to prescribe antiretroviral therapy was determined after discussion with infectious disease specialists. Blood tests for HIV, HCV and HBV were taken at months zero, three and six; all were negative. In the French Military Health Service, guidelines are based on evaluation of the viral status of the bomber and on the regional HIV prevalence breakpoint. There is no indication for HCV post-exposition prophylaxis (PEP). Accessible human foreign bodies related to an SBA should be removed as soon as possible, in association with antibiotic medication and a possibl...Continue Reading

References

Jun 5, 2003·Cleveland Clinic Journal of Medicine·Francisco Alvarado-Ramy, Elise M Beltrami
Jan 25, 2005·Injury·Zeev Eshkol, Kalman Katz
Jan 25, 2005·Injury·S EylonA Peyser
Mar 2, 2006·The Journal of Trauma·James Min-Leong WongHasu Patel
Jan 19, 2008·Sexual Health·UNKNOWN NPEP Reference Group, J Savage
Aug 19, 2009·Military Medicine·Brandon D Clint
Mar 13, 2014·International Orthopaedics·Laurent MathieuSylvain Rigal
Apr 1, 2012·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·T DienstknechtT C Hardcastle

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