Author Description

During the conflicts in Iraq and Afghanistan, there have been changes in the mechanism, severity, and complexity of injuries from improvised explosive devices-changes that have resulted in a higher incidence of combat-related traumatic injuries. Battlefield medical advances and improvements in protective equipment have resulted in a greater proportion of blast-exposed service members surviving their severe injuries, and progress in surgical reconstruction and rehabilitation has resulted in an increased medical capacity to salvage limbs. Collectively, these developments have led to important questions about when to emphasize limb salvage over other treatment options, most notably amputation, for individuals with severe blast-related limb injuries. To better understand limb salvage and recovery after severe blast-related injury, the authors conducted a literature review of recent research on the topic. They considered completed research addressing one or more of four objectives: (1) injury epidemiology and outcomes; (2) the clinical decision to salvage the limb; (3) the process of limb restoration and reconstruction; and (4) rehabilitation, reintegration, and recovery strategies. They found that although there is a vast literature on limb salvage, there is limited research on military blast-related limb salvage. The authors make several recommendations related to future research into limb salvage and recovery after severe blast injury.