Clinical Orthopaedics and Related Research®

, Volume 467, Issue 8, pp 2168–2191 | Cite as

Treatment of War Wounds: A Historical Review

  • M. M. Manring
  • Alan Hawk
  • Jason H. CalhounEmail author
  • Romney C. Andersen
Original Article


The treatment of war wounds is an ancient art, constantly refined to reflect improvements in weapons technology, transportation, antiseptic practices, and surgical techniques. Throughout most of the history of warfare, more soldiers died from disease than combat wounds, and misconceptions regarding the best timing and mode of treatment for injuries often resulted in more harm than good. Since the 19th century, mortality from war wounds steadily decreased as surgeons on all sides of conflicts developed systems for rapidly moving the wounded from the battlefield to frontline hospitals where surgical care is delivered. We review the most important trends in US and Western military trauma management over two centuries, including the shift from primary to delayed closure in wound management, refinement of amputation techniques, advances in evacuation philosophy and technology, the development of antiseptic practices, and the use of antibiotics. We also discuss how the lessons of history are reflected in contemporary US practices in Iraq and Afghanistan.


External Fixation Gunshot Wound Skin Traction Mafenide Medical Evacuation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Adrianne Noe, PhD, and the staff of the National Museum of Health and Medicine, Armed Forces Institute of Pathology.


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Copyright information

© The Association of Bone and Joint Surgeons 2009

Authors and Affiliations

  • M. M. Manring
    • 1
  • Alan Hawk
    • 2
  • Jason H. Calhoun
    • 3
    Email author
  • Romney C. Andersen
    • 4
    • 5
  1. 1.Department of Orthopaedic SurgeryUniversity of Missouri-ColumbiaColumbiaUSA
  2. 2.National Museum of Health and MedicineArmed Forces Institute of PathologyWashingtonUSA
  3. 3.Department of Orthopaedic SurgeryThe Ohio State UniversityColumbusUSA
  4. 4.Orthopaedic TraumatologyWalter Reed National Military Medical CenterBethesdaUSA
  5. 5.Orthopaedic TraumatologyWalter Reed National Military Medical CenterWashingtonUSA

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