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Initial Extremity War Wound Debridement: A Multidisciplinary Consensus
  1. Major HC Guthrie, Specialty Registrar1, Trauma and Orthopaedic Specialty Training Registrar,
  2. JC Clasper, Defence Professor Trauma and Orthopaedics2,
  3. AR Kay, Consultant Plastic Surgeon3 and
  4. PJ Parker, Senior Lecturer Limb Trauma and Wounds Working Groups, ADMST4
  1. 1London Deanery
  2. 2Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham
  3. 3Frenchay Hospital Bristol and Defence Consultant Advisor Burns and Plastic Surgery
  4. 4Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham
  1. Department of Trauma and Orthopaedic Surgery, Frimley Park Hospital, Portsmouth Road, Camberley, Surrey GU16 7UJ 01276 604604 01276 604457 hugoguthrie{at}


A joint meeting of the Limb Trauma and Wounds Working Groups resulted in the establishment of 29 consensus recommendations for the conduct of initial extremity war wound debridement. Pre-operative, operative and post-operative phases of debridement were considered along with wound irrigation and dressings. Wounds where a different surgical approach is required, such as superficial soft tissue wounds at one end of the spectrum and complex wounds sustained in close proximity to explosions at the other, were also discussed. The recommendations represent the consensus opinion of orthopaedic, vascular and plastic surgeons, as well as nursing officers, from across the Defence Medical Services and are intended to provide useful guidance to the deploying surgeon, regardless of their own personal experience.

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