Impact of infectious diseases on war

Smallman–Raynor, Matthew; Cliff, Andrew

doi:10.1016/j.idc.2004.01.009

Cited by 57 publications

(36 citation statements)

References 16 publications

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“…Worse yet, the lessons regarding shock and delayed primary closure, learned at great human expense in World War I, had to be relearned by Americans in World War II. Also, for most of the history of warfare, at least until World War II, disease usually killed at a higher ratio than battle wounds: nearly 8:1 in the Napoleonic Wars, 4:1 in the Crimean War, 2:1 in the Civil War, 7:1 in the Spanish-American War, and 4:1 in World War I [29,132]. In World War II, the ratio decreased to 0.1:1; in Korea and Vietnam, to 0.2:1; and in the 1992 Gulf War, to 0.1:1 [132].…”

Section: Discussionmentioning

confidence: 99%

Treatment of War Wounds: A Historical Review

Manring

Hawk

Calhoun

et al. 2009

Clinical Orthopaedics &Amp; Related Research

144

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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.

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Section: Discussionmentioning

confidence: 99%

Treatment of War Wounds: A Historical Review

Manring

Hawk

Calhoun

et al. 2009

Clinical Orthopaedics &Amp; Related Research

144

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“…The American forces in the Mexican War (1846-1848) and the Spanish-American War (1898) saw a similar mortality rate from disease. It was not until World War I (1914-1919) that battlefield deaths reached parity with disease-related deaths [50]. Improvements in the surgical management of wounds led to the gradual disappearance of clostridium-associated gas gangrene through the first half of the 20th century.…”

Section: Historical Perspectivementioning

confidence: 99%

Multidrug-resistant Organisms in Military Wounds from Iraq and Afghanistan

Calhoun

Murray

Manring

2008

Clinical Orthopaedics &Amp; Related Research

161

136

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Mortality from battlefield wounds has historically declined, thanks to better surgical management, faster transport of casualties, and improved antibiotics. Today, one of the major challenges facing U.S. military caregivers is the presence of multidrug-resistant organisms in orthopaedic extremity wounds. The most frequently identified resistant strains of bacteria are Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter calcoaceticus-baumannii complex. Overuse of broad-spectrum antibiotics may be an important factor in building resistant strains. Acinetobacter infections appear to hospital-acquired and not from an initial colonization of the injury. More research is required to give military physicians the tools they require to reduce the infection rate and defeat multidrug-resistant organisms.

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“…With improvements in sanitation and our understanding of how to prevent the infections associated with deploying armies, there have been substantial improvements in the mortality associated with these diseases during combat operations (1). The mortality of battle and wounds resulting from infectious diseases has markedly changed over the last century with the mortality ratio dropping from 1:8 during the Spanish-American War in 1898 to 1:.4 during World War I, 1:.1 during World War II, 1:.13 during the Vietnam conflict, and 1:.01 during the first Gulf War (2).…”

mentioning

confidence: 99%