Effectiveness of the combat XXXX in the prevention of genital and urinary tract injuries: An observational study.

@entity1 @entity3614 @entity5450 @entity530 @entity4875
BACKGROUND: Historically, the incidence of genital and urinary tract (GU) injuries in major conflicts has been approximately 5%. To mitigate the risk of @entity3614 to the external genitalia, the United States and United Kingdom issued protective overgarments and undergarments to troops deployed in support of Operation Enduring Freedom. These two systems combined constitute the @entity530 ( @entity4875 ). Our hypothesis was that @entity4875 use is associated with a reduction of @entity5450 in subjects exposed to dismounted improvised explosive device @entity3614 . METHODS: We identified two groups for comparison: those who were confirmed to have worn the @entity4875 at time of injury (n = 58) and a historical control group who were confirmed as not wearing the @entity4875 ( @entity4875 ) (n = 61). @entity1 with any level of lower extremity amputation from dismounted improvised explosive device blast mechanism were included. The primary outcome measure was presence of a @entity5450 on admission. A univariate analysis assessing the strength of association with odds ratios and 95% confidence intervals was performed between the @entity4875 and @entity4875 groups. RESULTS: Mean Injury Severity Score (ISS) was higher in the @entity4875 versus the @entity4875 group (26.1 vs. 19.3, p = 0.0012). Overall, 31% of the @entity1 in the @entity4875 group sustained at least one @entity5450 versus 62.3% in the @entity4875 group. The odds ratio of sustaining a @entity5450 in the @entity4875 group as compared with the @entity4875 group is 0.28 (31% vs. 62.3%; 95 % confidence interval, 0.62-0.12; p < 0.001). The most frequent injures were open scrotal/testes wounds, followed by open penis, and open bladder/urethra injuries. CONCLUSION: The use of the @entity4875 is associated with a decreased odds ratio of @entity5450 . Despite a 31% absolute reduction, future work should focus on improved efficiency. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level IV; therapeutic study, level V.
