Unique aspects of trauma due to thermobaric artillery weapon systems (specifically the Russian TOS-1A) during the war in Ukraine

This paper examines the unique trauma inflicted by the TOS-1A thermobaric weapon system during the conflict in Ukraine. The study aims to analyze the nature and severity of injuries caused by this thermobaric weapon system, comparing them with more conventional thermal injuries. Thermobaric weapons, like the TOS-1A, generate high temperatures and pressure waves without the fragmentation typical of traditional explosives, causing extensive internal and external damage. Data were collected from Role 2 mobile hospitals in various regions, focusing on individuals with thermal injuries. The study categorized patients into 2 groups: those with thermal trauma associated with weapons other than those specifically injured by TOS-1A weapons. The findings revealed that injuries from TOS-1A resulted predominantly in third- and fourth-degree burns, with significant upper respiratory tract damage and barotrauma. These injuries were more severe than general thermal injuries, which included a broader range of burn degrees. The study highlights the critical need for injury prevention and specialized medical response and treatment for such trauma, emphasizing the inefficacy of traditional protective structures against thermobaric weapons. The paper concludes with recommendations for improving survival rates, including prompt evacuation and advanced medical care in specialized burn centers.