Surgical experience in a combat zone

The surgical experience of an evacuation hospital in a combat zone was reviewed. During a thirty month period from January 1, 1966 through June 30, 1968, 6,927 casualties were admitted with 121 deaths, a mortality of 1.8 per cent. Hemorrhage was the most common cause of death. Sepsis was the second most common cause of death but was the most common cause of deaths occurring after the first twenty-four hours after admission. There were 652 positive laparotomies with seventy-nine deaths, a mortality of 12.1 per cent. Major intra-abdominal vascular and hepatic injuries were associated with a high mortality; and in those patients who died from sepsis, 80 per cent were associated with colon injuries. There were 198 vascular injuries repaired during the period studied and seventeen of these patients required amputation, a rate of 8.9 per cent. Associated massive tissue injury was the major cause of vascular repair failure. There were 367 intrathoracic injuries and in seventy-one of these (13.2 per cent) open thoracotomy was required, with a mortality of 8.4 per cent for intra-thoracic injuries.