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Infectious disease complications of combat-related injuries

Murray, Clinton K. MD

doi: 10.1097/CCM.0b013e31817e2ffc
Scientific Reviews

Background: Strategies currently used to prevent morbidity and mortality associated with combat-related injuries include better training of frontline medical personnel, improved personal protective equipment, and deployment of fast-forward surgical assets with state-of-the-art equipment. These strategies allow patients to survive near-catastrophic injuries, placing a greater emphasis on the medical infrastructure to mitigate short- and long-term complications associated with these injuries.

Discussion: Wounds have certain characteristics that promote the development of infections: the presence of devitalized tissue, foreign bodies, clots, fluid collections, and contamination of wounds with bacteria from the casualty’s skin, the environment, and the hospital. All of these factors culminate in placing the casualty at risk of developing an infection.

Summary: This article reviews the lessons learned from combat-related wound infections throughout history and in the current conflicts in Iraq and Afghanistan. Many of the management strategies used to prevent infections of combat-related injuries are applicable to the management of civilian trauma, whether associated with small arms fire or related to natural disasters such as earthquakes or tornadoes.

From the Brooke Army Medical Center, Fort Sam Houston, TX.

The views expressed herein are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.

The author has not disclosed any potential conflicts of interest.

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© 2008 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins