Viet Nam Wound Analysis

Treatment of War Wounds: A Historical Review

“…Improvements in surgical management stopped the scourge of Clostridium-associated gas gangrene, which had a 5% incidence and 28% mortality among US troops in World War I but had fundamentally disappeared by the Korean War [65]. Likewise, the mortality of patients with abdominal wounds declined from 21% in World War II to 12% in Korea and 4.5% in Vietnam [60]. Although the historical trend is reasonably clear, mortality rates can be deceiving, depending, for example, on how those wounded who quickly returned to action were accounted for statistically and aspects that cannot be quantified easily and that have nothing to do with medical advances.…”

“…4). Patients not expected to return to full duty within 30 days or less were evacuated to hospitals in Japan and the United States [60].…”

“…Patients frequently sustained multiple wounds from bursts of automatic fire or booby traps. Surgeons could receive patients as early as 1 to 2 hours after wounding [60,96], although in reality conditions during combat often delayed evacuation and resulted in an arrival time of 4 to 6 hours after wounding. On arrival, the patient was infused with Ringer's lactate and antibiotics.…”

“…Petit's second contribution was the modified tourniquet, with a screw to adjust tension, making bleeding during an amputation manageable (Fig. 6) [60]. [91].…”

“…Hardaway, in his classic study of 17,726 patients from 1966 to 1967, found a postoperative infection rate of 3.9%; however, as he noted, the study only included patients managed in Vietnam and not patients whose infections developed or became apparent later after evacuation [60]. The punji stick, a piece of sharpened bamboo placed in the ground, created lower extremity wounds with a 10% infection rate, but few fatalities.…”