Penetrating missile injuries during asymmetric warfare in the 2003 Gulf conflict

TLDR

War wounds impose a substantial burden on medical facilities, and training and resources must adapt to the changing nature of modern conflicts that increasingly involve urban or remote environments and non‑combatants. The study aimed to document the workload from the recent conflict to guide future medical needs. Prospective data on all war injuries were collected and reviewed, with the sole British field hospital admitting 482 casualties during the first two weeks of the conflict. During the first two weeks of the 2003 Gulf conflict, 482 casualties were admitted to the field hospital, of which 104 were battle injuries (including 9 burns), 79 underwent initial surgery by British military surgeons, 123 wounds were prospectively scored, 27 (34 %) were non‑combatants (8 children), and 4 patients (5 %) died.

Abstract

War wounds produce a significant burden on medical facilities in wartime. Workload from the recent conflict was documented in order to guide future medical needs.All data on war injuries were collected prospectively. This information was supplemented with a review of all patients admitted during the study period.During the first 2 weeks of the conflict, the sole British field hospital in the region received 482 casualties. One hundred and four were battle injuries of which nine were burns. Seventy-nine casualties had their initial surgery performed by British military surgeons and form the study group. Twenty-nine casualties (37 per cent) sustained gunshot wounds, 49 (62 per cent) suffered wounds from fragmentation weapons and one casualty detonated an antipersonnel mine. These 79 patients had a total of 123 wounds that were scored prospectively using the Red Cross Wound Classification. Twenty-seven (34 per cent) of the wounded were non-combatants; eight of these were children. Four patients (5 per cent) died.War is changing; modern conflicts appear likely to be fought in urban or remote environments, producing different wounding patterns and placing non-combatants in the line of fire. Military medical skills training and available resources must reflect these fundamental changes in preparation for future conflicts.