Soft Tissue Wounds and Fasciotomies
When you imagine “war surgery”, you probably conjure up visions of crashing into the chest or abdomen just in time to save a live. Although very dramatic, this will be relatively uncommon in your combat surgical practice. This chapter is dedicated to what will be your most common operative case in combat – operative management of soft tissue wounds. Thanks to modern body armor and vehicles, many of the previously fatal injury mechanisms are now producing less fatal, but still significant, soft tissue injuries. These injuries are devastating and we rarely see these extensive soft tissue injuries during our training in the US. The garden variety civilian stab wounds, slash wounds, and hand gun injuries are incredibly minor compared to the wounds produced by things like a 50 caliber machine gun, an AK47 round, or more commonly an explosive device. We simply just don’t see these wounds routinely in the US civilian trauma centers and thus don’t have a developed comfort level with the management and pitfalls. The high velocity stuff is just simply unreal and requires a different set of rules and strategies to optimize your patient’s outcome. No amount of reading can completely prepare you for some of these injuries. The goal of this chapter is to shorten the learning curve and have you mentally prepared before you are faced with one.