Wound Fragments from Cutaneous Sites of U.S. Military Personnel Deployed in Operation Iraqi Freedom: Clinical Aspects and Pathologic Characterizations

Authors


  • Disclaimer: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the U.S. Department of the Army or the U.S. Department of Defense.

Address correspondence and reprint requests to: Kurt L. Maggio MD, WRAMC Dermatology, Clinic 1J, 6900 Georgia Avenue NW, Washington DC 20307, or e-mail: kurt.maggio@na.amedd.army.mil

Abstract

BACKGROUND A wide variety of materials present in current military conflict zones may be implanted and retained as “foreign bodies” or fragments in wounds. Analysis of removed fragments can be valuable to the patient, for research purposes, and for the protection of future potential victims.

OBJECTIVES The objectives were to evaluate the composition of retained fragments in wounds from combat injuries and correlate this information with the mechanism of injury.

METHODS Wound fragments from 10 U.S. military personnel wounded while deployed in Iraq for Operation Iraqi Freedom were removed from their skin and were subjected to gross examination, light microscopy, and scanning electron microscopy/energy-dispersive X-ray analysis (SEM-EDXA), with specimen radiography and infrared spectroscopy if indicated.

RESULTS A variety of exogenous substances, including iron, lead, antimony, copper, aluminum, and acrylonitrile-styrene plastic were detected. No (depleted) uranium was detected. There was a high degree of correlation between the composition of the fragment removed and the wounding event.

CONCLUSIONS Wound fragments may take months to years to manifest. Their gross appearance can be misleading. Establishing the composition of retained materials in wounds may assist in the clinical care of the wounded, provide forensic information, and have broader value in wound analysis and research.

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