Infection is an important consideration in war wounds. Improvements in survival and use of increasingly broad-spectrum antibiotics have led to new challenges with novel pathogens and conventional pathogens with multiple drug resistance patterns.. learnt in conflicts centuries ago. The cornerstone remains early, appropriate and repeated surgery. Antimicrobial agents contribute a very minor part to overall patient outcome, but prudent use of antibiotics and good infection control is essential to prevent establishment and spread of hospital-acquired infections. Research in progress will provide an evidence base for antibiotic and infection control policies and baseline data for research into novel wound management strategies.

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Maintaining a strong infection control effort in the deployed setting, even in a stabilised operational environment, is difficult, but our data show good compliance to the antimicrobial formulary superior to that reported in civilian hospitals. To improve this, further innovative strategies are required, combined with a continued focus on infection control basics across the full spectrum of care.