• Anders Sondén, David Rocksén, Louis Riddez, Johan Davidsson, Jonas K Persson, Dan Gryth, Jenny Bursell, and Ulf P Arborelius.
• Department of Clinical Science and Education, Karolinska Institutet at Södersjukhuset, Stockholm, Sweden. anders.sonden@sodersjukhuset.se
• J Trauma. 2009 Dec 1;67(6):1191-9.

BackgroundBody armor is used by military personnel, police officers, and security guards to protect them from fatal gunshot injuries to the thorax. The protection against high-velocity weapons may, however, be insufficient. Complementary trauma attenuating backings (TAB) have been suggested to prevent morbidity and mortality in high-velocity weapon trauma.MethodsTwenty-four Swedish landrace pigs, protected by a ceramid/aramid body armor without (n = 12) or with TAB (n = 12) were shot with a standard 7.62-mm assault rifle. Morphologic injuries, cardiorespiratory, and electroencephalogram changes as well as physical parameters were registered.ResultsThe bullet impact caused a reproducible behind armor blunt trauma (BABT) in both the groups. The TAB significantly decreased size of the lung contusion and prevented hemoptysis. The postimpact apnea, desaturation, hypotension, and rise in pulmonary artery pressure were significantly attenuated in the TAB group. Moreover, TAB reduced transient peak pressures in thorax by 91%.ConclusionsOur results indicate that ordinary body armor should be complemented by a TAB to prevent thoracic injuries when the threat is high-velocity weapons.

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