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
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Reviewed
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:
- 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.
- 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.
- 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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