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Army Teams Face Surgeon Shortage
A severe shortage of surgeons in Iraq has left U.S. Army medical teams scrambling to handle the largest number of casualties since the Vietnam War, the New England Journal of Medicine reports.

WASHINGTON — A severe shortage of surgeons in Iraq has left U.S. Army medical teams in the country scrambling to handle the largest number of casualties since the Vietnam War, the New England Journal of Medicine will report Thursday....

...The system focuses on damage control, not definitive repair, Gawande writes. Field doctors carry "mini-hospitals" in Humvees and field operating kits in backpacks so they can move with troops and do surgery on the spot.

They limit surgery to two hours or less, often leaving temporary closures and even plastic bags over wounds, and send soldiers to one of several combat support hospitals in Iraq with services like labs and X-rays.

The strategy seems to be working. Although at least as many U.S. troops have been wounded in combat in the Iraq war as in the Revolutionary War, the War of 1812 or the first five years of Vietnam, 90% are surviving their injuries, compared to 76% in Vietnam. In that war, almost all of the wounded who died did so before they could reach MASH units-military surgery facilities — some distance from the fighting.

But the survivors today often have injuries so severe and maiming that their prospects are uncertain, Gawande writes.

Gawande writes about the case of an airman who lost both legs, his right hand and part of his face.

"How he and others like him will be able to live and function remains an open question," Gawande writes.