Abstract
Conflict in the Middle East has seen a change in warfare tactics from the use of ballistic missiles to blast weapons. This has resulted in a change in wounding patterns. Due to the severity of the injuries, there have been large numbers of amputations, as life and limb saving procedures.
The purpose of this paper was to retrospectively review all the amputated limbs over the past 8 years of conflict and compare those from the early years to the more recent ones. In particular, the aim was to examine differences in the mechanisms of injury, number of limbs injured, associated injuries, method of amputation, microbiology of contaminating organisms and outcome.
There were significantly more amputations, injured limbs and soft tissue perineal wounds as well as a significantly higher ISS in the later group. There were also significant differences in the surgical techniques, with more guillotine amputations in the early group, and mechanism of injury, with more blast injuries in the late group.
This confirms the clinical impression that there has been a significant change in limb trauma from Iraq to Afghanistan. These injury patterns have significantly different logistical implications, which must be considered when planning the required medical assets in future conflicts.
