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Robin M. Coupland, MB, B Chir, FRCS

JAMA. 1993;270(5):624-626.

Abstract
Objectives.
—To describe how noncombatants are injured by hand grenades in camps for displaced people, and to categorize grenade wounds according to the Red Cross wound classification.

Design.
—Case series.

Setting.
—A surgical hospital in Khao I Dang refugee camp on the ThailandCambodia border.

Patients.
—Seventy-four patients injured by hand grenades.

Interventions.
—Intravenous antibiotics and primary wound surgery.

Main Outcome Measures.
—Combatant status of the patients, categorization of the wounds, surgical outcome, number of operations, and number of blood transfusions.

Results.
—Only 7% of the patients sustained their wounds in battle and 50% were women, children, or older men. Seventy had 91 wounds that could be categorized; 59% of the wounds were small, affecting only soft tissue. Few wounds were associated with fractures and none with comminuted fractures. Twenty-four soft-tissue wounds were treated conservatively with minimal morbidity and no mortality.

Conclusions.
—Missiles (fragments or bullets) from hand grenades tend to produce wounds with little tissue damage. Serious injury is due to penetration of vital structures. The results permit a recommendation that certain small and uncomplicated fragment wounds can be treated initially without surgery.

(JAMA. 1993;270:624-626)

Author Affiliations
From the Medical Division, International Committee of the Red Cross, 17 Av de la Paix, CH1202, Geneva, Switzerland.

Footnotes
Reprints not available.

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