BMJ  2005;330:1498-1500 (25 June), doi:10.1136/bmj.330.7506.1498

Clinical review

ABC of conflict and disaster

Principles of war surgery

Steve J Mannion, consultant orthopaedic surgeon and honorary lecturer

Leonard Cheshire Centre of Conflict Recovery, University College London, London.

Eddie Chaloner, consultant vascular surgeon

University Hospital Lewisham, London.

The first 150 words of the full text of this article appear below.

Introduction

Managing war injury is no longer the exclusive preserve of military surgeons. Increasing numbers of non-combatants are injured in modern conflicts, and peacetime surgical facilities and expertise may not be available. This article addresses the management of war wounds by non-specialist surgeons with limited resources and expertise. One of the hallmarks of war injury is the early lethality of wounds to the head, chest, and abdomen; therefore, limb injuries form a high proportion of the wounds that present at hospitals during conflicts.


Figure Removed (Available Only in the Full Text)
 Healing amputation stump

 

Wounding patterns

The incidence of gunshot wounds in conflict depends on the type and intensity of the fighting. In full scale war the proportion of casualties injured by gunshot is generally less than in low intensity or asymmetric warfare.


Figure Removed (Available Only in the Full Text)
 Cavitation secondary to high energy transfer bullet wound

 

Bullets cause injury by:

  • Direct laceration of vital structures
  • Stretching of tissue (cavitation), causing fracturing of blood vessels and devitalisation . . . [Full text of this article]

Treating war injury


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