Anti-Personnel Mine Injuries: Experience from a Thirty Year Conflict (pp. 281-286)
Authors: (Thisara Weerasuriya, Narendra Pinto, The National Hospital of Sri Lanka, Sri Lanka, and others)
Abstract: Introduction: This work was done during a ten year period in Sri Lanka from 2000 to 2010 at the height of a civil war that ravaged the country for a thirty year period. A total of 1372 patients were treated with anti-personnel mine blast injuries to the lower limb resulting in complex compound injuries to the foot ankle regions. Anti-personnel mines are small devices manufactured by the insurgent groups and buried in thousands in battle ridden areas to prevent advancement of enemies. Though they are not powerful enough to kill a person, the blast rips off the foot and the blast wave causes the soft tissues of the lower tibial region to be dissected off and debris being driven in.
Objectives: The objective of this prospective study was to understand the best method of treating this unique injury as this was not encountered in previous practice.
By treating 1372 patients who had sustained lower limb injuries due to this unique type of blast injury the limitations of conservatory surgery and the need for radical debridement was understood.
Methods: This was a prospective study carried out in a tertiary care centre over a period of ten years. When a patient was admitted with an antipersonnel mine injury they were followed up prospectively during admission as well as post operatively with the mean follow up being one year.
Initially the approach was to treat the victims of this injury in a conservative manner by refashioning the traumatic amputation stump or by performing primary below knee amputations on those who sustained mangled feet.
With the prospective study in progress more radical higher level amputations were carried out as the primary procedure.