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TUESDAY, June 17 (HealthDay News) -- As the war in Iraq shifted after the fall of Baghdad to one in which U.S. troops were battling insurgents, the types and severity of injuries suffered by the Marine Corps became more severe and deadly.
That's the finding of a new report by a former U.S. Navy physician who served twice in Iraq. In the second "insurgency" phase of the war, it has also taken longer to transport the wounded to medical care, resulting in more Marines dying from their wounds, the report said.
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The primary reason for the changes in the Iraq war owe to changes in the nature of the battlefield, said Dr. Stacy A. Brethauer, a staff surgeon at the Cleveland Clinic. "It's an urban battlefield and improvised explosive devices have changed the injury patterns," he said. "The type of battle has changed, and that is reflected in the types and severity of injuries."
"We found a difference in the severity of casualties and the overall mortality rates within the 1st Marine Expeditionary Force when we compared the use of a forward mobile surgical unit during the invasion compared to the insurgency," Brethauer added.
The Iraqi invasion was the first time forward mobile surgical units were used. These units can provide almost immediate surgical care to wounded front-line troops, Brethauer said.
When the 1st Marine Expeditionary Force returned to Iraq 2004, those surgical units were still used, but in a different way, Brethauer said. "They were positioned in stationary locations, and they did not move while we were there," he said.
"We looked at the data from the first invasion to what we were experiencing during the insurgency," Brethauer said. "We saw significant differences in the severity of wounds we were seeing and the number mortalities we were seeing."
The findings are published in the June 16 issue of the Archives of Surgery.
For the study, Brethauer's team looked at records from a combat trauma database for 338 casualties treated during the first phase of the war, as well as 895 casualties during the insurgency phase. Compared with the initial phase of the war, there were more major injuries per Marine during the insurgency (2.4 compared to 1.6). There were also more fragment wounds during the insurgency, (61 percent versus 48 percent). But, there were fewer gunshot wounds during the insurgency (33 percent compared to 43 percent), the report found.
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