Penetrating missile injuries during asymmetric warfare in the 2003 Gulf conflict

Br J Surg. 2005 May;92(5):637-42. doi: 10.1002/bjs.4911.


Background: War wounds produce a significant burden on medical facilities in wartime. Workload from the recent conflict was documented in order to guide future medical needs.

Methods: All data on war injuries were collected prospectively. This information was supplemented with a review of all patients admitted during the study period.

Results: During the first 2 weeks of the conflict, the sole British field hospital in the region received 482 casualties. One hundred and four were battle injuries of which nine were burns. Seventy-nine casualties had their initial surgery performed by British military surgeons and form the study group. Twenty-nine casualties (37 per cent) sustained gunshot wounds, 49 (62 per cent) suffered wounds from fragmentation weapons and one casualty detonated an antipersonnel mine. These 79 patients had a total of 123 wounds that were scored prospectively using the Red Cross Wound Classification. Twenty-seven (34 per cent) of the wounded were non-combatants; eight of these were children. Four patients (5 per cent) died.

Conclusion: War is changing; modern conflicts appear likely to be fought in urban or remote environments, producing different wounding patterns and placing non-combatants in the line of fire. Military medical skills training and available resources must reflect these fundamental changes in preparation for future conflicts.

MeSH terms

  • Abdominal Injuries / epidemiology
  • Adolescent
  • Adult
  • Amputation, Surgical / statistics & numerical data
  • Blast Injuries / epidemiology
  • Child
  • Child, Preschool
  • Craniocerebral Trauma / epidemiology
  • Female
  • Humans
  • Infant
  • Injury Severity Score
  • Iraq
  • Kuwait / epidemiology
  • Male
  • Middle Aged
  • Neck Injuries / epidemiology
  • Prospective Studies
  • Thoracic Injuries / epidemiology
  • Warfare*
  • Wounds, Gunshot / epidemiology
  • Wounds, Penetrating / epidemiology*