Extremity trauma in wartime: Lessons learned from recent conflicts

The lessons learned from recent wars about the treatment of extremity wounds reflect both the fundamentals of basic wound treatment and improvements in general medical care, support, surgical techniques, and communication. As a result of these improvements, or in spite of these improvements, the basic principles of wound treatment are at continual risk of being slighted. There remains a relative lack of commitment to maintain the highest standards of technical competence associated with a transition of peace to war, because of our propensity to abhor war. Herein we describe changes in combat casualty care over the past 30 years, to include the changes in medical support, communication, and techniques that affect the treatment of extremity wounds. We reemphasize the importance of understanding and applying the basic principles of wound care introduced by Ollier in the late 19th century and reiterated and further refined by Trueta. The principles of early and adequate debridement and stabilization of associated fractures continue to be the hallmarks of extremity trauma care in any context. © 1995 Lippincott-Raven Publishers, Philadelphia.

Duke Scholars

Author Dean Curtis Taylor Orthopaedic Surgery