![]() This paper provides a review of infection in combat wounding from a historical setting through to the modern evidence base.ġ. Infection in conflict wounded-historical background Addressing antibiotic use, nosocomial transmission and infectious sequelae are a current clinical management and research priority and will remain so in an era characterized by a massive burden of combat extremity injury. Infectious complications in those that do survive, however, are a major concern. Advances in medical doctrine and technology afford those injured in current conflicts with increasing survivability through rapid evacuation, sophisticated resuscitation and timely surgical intervention. Concurrent advances in sanitation and evacuation enabled improved outcomes and establishment of modern military medical systems. Later, microscopy enabled identification of microorganisms and characterization of wound flora. Napoleonic surgeons eventually abandoned this mantra, embracing radical surgical intervention, primarily by amputation, to prevent infection. ![]() ![]() Battlefield surgeons of ancient times favoured suppuration in war wounding and as such Galenic encouragement of pus formation would hinder progress in wound care for centuries. Although mechanisms of modern military wounding may be distinct from those of ancient conflicts, the infectious sequelae of ballistic trauma and the evolving microbial flora of war wounds remain a considerable burden on both the injured combatant and their deployed medical systems. ![]()
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