War wounds and orthopedic trauma devices

The combined wars in Iraq and Afghanistan represent the longest ongoing conflicts in American military history, with current statistics showing more than 59,000 casualties wounded in action. Ultimately, combat-related extremity injuries require the longest inpatient stay (10.7 days), are responsible for 64% of total inpatient resource utilization, and disable 64% of those injured. Many of these patients require multiple surgical procedures, putting those with severe injuries and prolonged hospitalizations at risk for nosocomial and delayed infections, which we have only begun to evaluate systematically in the more recent conflicts. This chapter presents techniques for the initial management of war wounds, war wound infection, combat-related osteomyelitis, orthopedic device-related infections, fungal wound infections, as well as contemporary research and innovative approaches that have potential to move the field forward.