Traumatic amputations

With continued improvement in body armor and ballistic helmets as well as advances in modern combat casualty care, more and more combat casualties will survive following injury long enough to be resuscitated; therefore, the severity of extremity injuries among survivors of combat injuries will likely continue to increase. The primary mechanism for these injuries is blast and penetrating trauma, which is an unusual mechanism of injury in civilian medicine, even at Level I trauma centers. This must be understood in the context of overall patient management due to the systemic effects of blast and also in the management of the traumatic amputation when assessing the zone one injury in the injured extremities. Trauma surgery in a combat zone requires adaptation to a different injury paradigm.