A Lessons-Learned Legacy

Abstract

Abstract : The combat casualties of war have always provided society with substantial advances in knowledge and care of injury. The casualties of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) are no exception. A serious sampling of the lessons learned from caring for these wounded soldiers and Marines and subsequent research initiatives are published in this Supplement to the Journal of Trauma as a result of the endeavors of the young healthcare teams at the vanguard. Many of these scholarly dispatches were created and completed in the war zone. We should all appreciate and respect their contribution and recognize the birth of a new generation of trauma expertise. To fully comprehend this achievement, however, it needs to be placed in some historical context. After lessons learned in World War I had been relearned and integrated into combat casualty care in the second half of World War II, the died of wounds (death after reaching a physician-staffed medical treatment facility) rate fell substantially. This was sustained with further improvements in care in Korea and Vietnam. In the latter conflict, 153,303 Americans were seriously injured and 58,209 were killed,1 with 16,592 deaths in 1968 alone. During that conflict, the Army Chief of Staff, General Creighton Abrams, ordered a detailed evaluation of weapons effectiveness and dispatched seven teams to gather tactical, weapon, and wound information. This Wound Data Munitions Effectiveness Team (WDMET) database contained 7,989 combat injuries, about a 5% sample of those seriously injured in Vietnam. Despite its purpose assessment of weapons effectiveness and the fact that it has been sparsely studied, the WDMET database has driven a lot of combat casualty doctrinal thinking since that time.