Innovative Care Is Helping Iraq War's Injured Survive

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Wounded soldiers are also transported to hospitals more quickly than ever before, thanks to C-17 Medevacs. "They are really flying ICUs with 12 beds, equipment for resuscitation, IV fluids and more. Just as an ambulance does on the civilian side, the C-17 Medevacs provide damage control," said Habal, who was an army reserve colonel called to active duty during the first Iraq conflict, Operation Desert Storm.

Using advanced trauma care and surgical techniques, craniofacial surgeons have made important strides in managing the often devastating head and face injuries suffered by not only US soldiers but Iraqi civilians.

For example, Iraqi surgeon Dr. Raja K. Kummoona writes in the JCS on his experience treating 141 patients at the Specialized Surgeries Hospital in Baghdad. Many suffered from severe facial injuries caused by projectiles such as bullets and shrapnel. He outlines his unit's surgical approach, which includes using bone grafts to reconstruct the mandible (lower jaw) and soft tissue reconstruction of the lips and cheeks.

"One 13-year-old girl had a severe injury involving the floor of her mouth, tongue and lower face caused by a rifle bullet at close range. She was brought to the hospital and we controlled her airway, blood pressure and bleeding and then immediately reconstructed the soft tissue, stabilized the bony fragments in position. We were able to restore her face," said Kummoona.

"We've learned the early operative repair of the orofacial region and the reconstruction of the soft tissue position is critical in obtaining optimal aesthetic and functional results. We've also found it is important that the remaining segments of the maxilla and mandible be held in an anatomic position through the period of soft tissue and bone reconstruction to limit the magnitude of the deformity," he stated.

The results, revealed in photos that accompany the journal articles, are remarkable. They show horribly scarred and misshapen faces transformed into faces that often appear virtually normal.