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Extremity Injury in War: A Brief History

Dr. Noe is Director, National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, DC.

Neither Dr. Noe nor the department with which she is affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.

The opinions or assertions herein are those of the author and do not necessarily reflect those of the Army, Navy, Air Force or of the Department of Defense.

The complex history of treating traumatic injury in Western warfare consistently included issues such as proximity to surgical care, the organization of medical systems, and the progressive development of technologies and procedures used to treat military service members who are injured in battle. Significant advances have been made in each of these areas, as evidenced in the changes in medical care in conflicts involving US forces. These advances include, among others, organized attempts to improve sanitation; panels of surgeons to assess optimal surgical approaches; the introduction of triage, wound débridement, and delayed wound closure; the development of chemotherapeutics and antibiotics; and increasingly more timely treatment. Perhaps the least recognized historical contribution to military medical care, however, is the compiled medical statistic, which informs bold research and response.

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