Mobile Army Surgical Hospital Case Study

Mobile Army Surgical Hospitals (MASH) were widespread during the Korean War (1950–1953) Thus patients were immediately transported from the battlefield and wounds were managed within 2-4 hours from the injury. The standard practice of wound care for victims of the Korean War included antibiotic prophylaxis using penicillin and streptomycin, adequate wound debridement and delayed closure or wounds (23,30).
Transportation facilities were refined even further during the Vietnam War (1959–1975) where helicopters were used for rapid transport of patients. Thus surgical wound care could be administered within 1 to 2 hours (30). External fixators were used for wounds with large soft tissue defects. Tibial plates were introduced by Mc Neur during this time. Mortality rates of open femur fractures were as low as 3-4%.
During the United States ‘invasion in Panama (1989–1990) there were 9 reported infected open fractures out of 37 open fractures. There were a total of 18 type III injuries, 9 of which underwent debridement at Panama and the remaining in the United States It was reported that only 2 of the fractures treated at Panama itself got infected as

Sushrata and Hippocrates stated that distal limb amputations could be tolerated well and obviated need for use of a tourniquet to control bleeding. Later Celcus, a Roman surgeon popularized the technique of ligating major vessels during amputations to control bleeding. John Jones (1729–1791) was the first to emphasize the importance of life over limb in his textbook published on management of surgical wounds and fractures during the American independence war. He advocated that the need to amputate limbs as part of a lifesaving procedure was primarily the decision of the operating surgeon. The importance of his guidance for the war surgeon was the emphasis of life before limb and the need for adequate