Penetrating missile injuries in the Gulf War 1991

Abstract During the Gulf War in 1991 63 patients (including 29 Iraqi prisoners of war) with penetrating missile injuries underwent surgery in a British Army Field Hospital. Their injuries and initial operative management are reported. Fifty-one casualties (81%) suffered an average of nine wounds (range 1–45) due to fragmentation weapons, and 12 casualties sustained bullet wounds. All wounds were explored following the established principles of war surgery. The extremities were involved in 48 patients (76%). Eight compound long bone fractures were managed with external skeletal fixators applied at the time of initial surgery. Laparotomy was performed on seven patients, one of whom died. The average duration of surgery was 77 minutes for fragment wounds and 85 minutes for bullet wounds.