An experience of war surgery and wounds presenting after 3 days on the border of Afghanistan.

The International Committee of the Red Cross (ICRC) has run hospitals for the wounded of the conflict in Afghanistan since 1981. For political and geographical reasons the hospitals are situated in Pakistan, some distance from the fighting, and so the wounded may take many days to arrive. This has enabled a surgical team provided by the British Red Cross Society to observe wounds of varying age and degrees of putrefaction or healing. Twenty-nine (29) patients with wounds of 3 or more days are detailed. The old wounds showed a tendency either to putrefaction or healing and the surgical management had to be revised accordingly. Wounds sutured in the field tended to putrefy. Among the various problems, the most taxing and difficult were the cultural and religious objections to amputation. The ICRC is committed to providing surgical hospitals for the Afghan war wounded for as long as the conflict lasts. It has adapted the local facilities and staff to the particular political, geographical and cultural situation.