Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXXII: Wounds and Injuries of the Hand

Care in the Division Area

United States Department of Defense

Care of the wounded hand in the division area is limited to control of hemorrhage and immobilization by a compressive dressing (Figure 39). The immobilized extremity is elevated. Antibiotic therapy is initiated and the wounded soldier evacuated to a facility with roentgenographic and surgical capabilities.

Figure 39

Should the tactical situation preclude early evacuation, the following additional measures are recommended:

1. Wrist watches and rings are removed. The hand is thoroughly cleansed with soap and water. The combatant's fingernails, which in combat are usually filthy, are clipped and cleaned.

2. Shreds of obviously dead tissue are excised. Amputation of digits is rarely indicated. If amputation appears necessary, it is done later, after the opportunity for more careful evaluation and planning.

3. Oozing is controlled by the application of a generous gauze dressing. Petrolatum-impregnated gauze and grease in any form should be avoided. The hand is immobilized in the position of function.

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Operational Medicine 2001

Health Care in Military Settings

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