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Military Wounds and War Injuries: A Narrative Review of Mechanisms, Pathophysiology, Classification and Evidence-Based Management
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Mosa Ahmadi   , Mohsen Yosefzadeh , Masoud Kerman-Saravi , Ahmadi Shahed , Robati Dariush |
| Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran |
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Abstract: (25 Views) |
Introduction: Combat-related wounds differ from civilian trauma
in energy transfer, extent of tissue destruction, initial contamination
burden, and the logistic environment of care. Two decades of experience
from Iraq and Afghanistan, and more recently data from the
Russo-Ukrainian war, have redefined both injury patterns and the microbial
ecology of these wounds. This review integrates current surgical,
orthopedic and infectious-disease evidence on military wounds.
Methods: A structured narrative review. PubMed/MEDLINE, Scopus,
Web of Science, Cochrane, Embase, Google Scholar and Magiran
were searched (1990 – July 2026), together with Joint Trauma
System Clinical Practice Guidelines, CoTCCC TCCC Guidelines,
ICRC war-surgery references and Emergency War Surgery.
Results: Military wounds fall into seven mechanistic categories that
frequently coexist. Their pathophysiology is governed by kinetic energy
transfer, temporary and permanent cavitation, ischemia-reperfusion
injury, systemic inflammation, and acute traumatic coagulopathy.
Wound infection follows a time-dependent ecology: skin flora and
clostridia predominate at the point of injury, whereas multidrug-resistant
organisms are largely acquired along the evacuation chain.
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Conclusion: Survival of the war wounded now depends less on hemorrhage
control alone and more on wound management quality, prevention
of resistant infection, and physical and psychological rehabilitation.
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Article number: 07 |
| Keywords: military wound, war trauma, gunshot wound, blast injury, wound infection, antimicrobial resistance, tactical combat casualty care, damage control surgery |
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Full-Text [PDF 3415 kb]
(13 Downloads)
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Type of Study: Research |
Subject:
Special
Received: 2026/10/5 | Accepted: 2026/10/10 | Published: 2026/10/10
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