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Injury profile suffered by targets of antipersonnel improvised explosive devices: prospective cohort study
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  • Published on:
    Important issues for casualty trauma care and an ethical plea

    The authors accomplish to objectify the experiences of military surgeons collected in current military conflicts by this scientific study and manage to give practical guidelines for the treatment of the sustained injuries.

    Especially the significance of multiple amputations and perineal injuries as indicators of more severe injuries (e.g. pelvic fractures) due to a massive transfer of energy is highlighted. These patients are at a higher risk of exsanguination and infection. First important measures can be applied in the field by the attending medic: the liberal use of tourniquets and pelvic binders cannot be stressed enough. A finding that even has impact on the civilian sector. With an increase of terroristic attacks we can implement the knowledge which was won in military conflicts.

    Moreover we may not neglect the effects of these injuries onto the whole life of the patients which are mostly young men. A lot of subsequent problems have to be expected that represent major challenges for both the patients and the societies. Especially as a result of ageing many patients will compensate their lost limbs to a lesser extent over time.

    Beyond the medical findings this paper stands out especially because of its ethical assessment of AP-IED’s. It was utterly justified to outlaw the use of APM’s, in today’s conflicts APM’s only play a minor role. A similar process concerning the AP-IED’s is extremely desirable which even have more gruesome effects as shown...

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    Conflict of Interest:
    None declared.
  • Published on:
    Thanks for your Comments related to International Humanitarian Law

    Thanks for your comments and I agree it is difficult to address Rule 70 in countries who do not subscribe to the conventions. However this does not negate the need for continued efforts to add AP-IEDs to the list of weapons that cause excessive injury or suffering that is disproportionate to the military advantage sought by their use, and only by only by documenting and publishing these injury patterns can we offer the necessary evidence. The data also suggests the indiscriminate nature of this weapon - in that children were part of the co-hort – and this also needed to be identified.

    Conflict of Interest:
    None declared.
  • Published on:
    International Humanitarian Law: Rule 70

    The authors of this article claim that they document this weapon to cause "superfluous injury and unnecessary suffering". This is terminology that refers to International Humanitarian Law. The International Committee of the Red Cross have catalogued these laws. Rule 70 states that "the use of means and methods of warfare which are of a nature to cause superfluous injury or unnecessary suffering is prohibited."(1) Some would say that there is no point to pursuing this legal angle because those who use IEDs tend not to be among those who sign on to the Geneva conventions. However International Humanitarian Law is considered to be customary and therefore applicable to every human being regardless of the law, or absence of law, in their own country.

    (1) https://ihl-databases.icrc.org/customary-ihl/eng/docs/v1_rul_rule70

    Conflict of Interest:
    None declared.