Post Gulf war explosive injuries in liberated Kuwait.

We collected the statistics of the victims affected by explosive injuries in liberated Kuwait during the period March to December 1991. Included were 1679 patients treated at nine different hospitals in Kuwait. As members of a trauma team, we, the plastic surgeons, were involved in the care of 152 victims of explosive injuries admitted at Al-Razi Orthopaedic Hospital. The records of these patients were reviewed in detail and the results were analysed. Of the patients, 58 had penetrating wounds and 94 explosive blast wounds. In all, 69 patients (45.3 per cent) were found to have associated fractures, 8 (5.3 per cent) had vascular injuries and in 10 (6.5 per cent) a nerve was also involved. There were 41 patients (26.9 per cent) who required amputations. The mainstay of surgical treatment was adequate wound excision, skeletal fixation and soft tissue coverage. Split-skin grafts were used in 34 patients, local flaps in seven and free flaps in four. Most patients healed within 2-3 weeks. There were 10 patients with explosive blast wounds who developed infection and needed staged wound excision before providing final coverage.