COMBAT-INJURED personnel of the US Armed Forces in Vietnam are being brought into medical treatment channels at an earlier time postinjury than heretofore possible.1 As a natural sequence many cases are evacuated to the United States, when their general condition permits, arriving as early as three to ten days postinjury.
It is justifiable to pay tribute to those who are caring for these problems initially in Vietnam. The successful subsequent course bears a direct relationship to the quality and integrity of the initial wound surgery. We have had few complications resultant from inadequate or improper initial management. A steady percentage of 10% have required redebridement. The overzealous removal of excessive tissue in primary debridement, however, is not desirable and some redebridement seems justifiable.
The educational challenge proposed by Churchill in 1953 has not been completely met. He said:
Despite a decade of preaching the gospel of the no primary-suture management
Metz CW, Barclay WA. Management of War Wounds in the Continental United States. Arch Surg. 1968;97(5):707–715. doi:10.1001/archsurg.1968.01340050047005
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