Since World War 2, The use of antipersonnel mines (APMs) have been a key factor in a nation’s military success. The most recent iteration of the APM is the improvised explosive device (IED) often seen in the Global War on Terror (GWOT), utilized by terrorist and guerrilla groups that do not have the manufacturing capabilities of an established military. IEDs have been proven to cause greater damage to their victims than conventional APMs, and the often resulting amputations call for a much more complicated rehabilitation process for service members.
A study conducted by Smith et al. analyzed 100 victims of pattern 1 IED injury victims as compared to conventional APM victims. A pattern 1 injury includes injuries caused by a direct step onto the mine itself. The results showed that 70% of IED victims had multiple amputations, as opposed to 10.4% of APM victims suffering multiple amputation. It was also discovered that the blast forces, paired with the uncontrolled shrapnel launch of an IED results in more mangled and contaminated wound sites.
Smith at al.
For those victims fortunate enough to survive an IED attack, they often continue to face further complications in their recovery process. For the victim of a conventional APM, a large shockwave has the ability to violently accelerate their appendages which act as lever arms to the point of joint failure and forcible amputation. IEDs, contrary to conventional APMs, are often buried underground in the form of roadside bombs. The mechanics involved in this blast causes more shrapnel in the form of soil to be forced into the victims body in addition to the violent shockwave that may cause amputation. Because of this, they tend to cause a great deal of soft tissue damage due to soil projectiles imbedding into the patient (Smith et al.). These soil projectiles would also cause a greater risk of infection. These complications cause a direct need for additional surgeries for repair of the fragile tissue which can further delay the recovery time and risks losing key limb dexterity.
An additional need for surgeries causes a risk of infection, tissue necrosis, and pain for the patient. The maintenance of the residual stump of the patient is also greatly complicated (Choo et al.). Reduction of stump edema, a buildup of blood and fluid causing swelling, often due to irregular regrowth of bone structure, is crucial to ensuring effective rehabilitation and a well fitting prosthetic. For those who have a desire to return to a normal lifestyle, this rehabilitation process must be successful.
Most US Service members, especially those who tend to hold combat positions live very active lifestyles. According to a study conducted through individual questionnaire by Kars et al. people who participated in physical activity before their amputation have a tendency to return to such activity. Unfortunately for service members, this can be a difficult task to achieve given the more in-depth, complicated recovery process for IED injuries. The frustrations associated with the longer, sometimes unsuccessful, recovery period have resulted in 12.3% of victims screening positive for depression (Mitchell et al.).
IEDs have caused an increasing impact on US forces in combat environments. The Congressional Research Service found that nearly half of all US casualties in the GWOT were caused by IEDs. For the soldiers that survived these horrible attacks, the return to a normal life back home is very challenging and provides a harrowing look into the realities of modern war.
Read More:
https://www.britannica.com/technology/improvised-explosive-device