title: Wounds of war in the civilian sector: principles of treatment and pitfalls to avoid.
abstract: BACKGROUND
  Terror attacks with explosive devices or mass shootings have introduced a new pattern of injuries into the civilian sector. The aim of this short review on the treatment principles for so-called penetrating war wounds is to remind surgeons who are not normally confronted with them of some basic rules to follow and pitfalls to avoid.
  
  
  METHODS
  This review article is based on literature research of the National Library of Medicine and the National Institutes of Health MEDLINE database using PubMed, as well as updated books on war surgery and the author's own experience of war zones.
  
  
  CONCLUSIONS
  Principles of treatment of penetrating war injuries to the head, neck, and torso are all based on damage control surgery focusing on hemorrhage and contamination control and early restoration of the deranged physiology. For injuries to the extremities, differences in treatment principles between low- and high-energy wounds are more important, although initial treatment is also focused on hemorrhage control. The surgical treatment should be based on thorough wound examination and debridement as well as fracture stabilization when required.
  
  
  CONCLUSIONS
  Certain knowledge of the treatment of war wounds is necessary in all civilian hospitals that receive patients injured in terror attacks.
authors.affiliation: Karolinska University Hospital, Stockholm, Sweden. louis.riddez@karolinska.se.
authors.forename: L
authors.initials: L
authors.lastname: Riddez
keywords: Ballistics; Terror attacks; Terror bombings; War wounds; Wound debridement
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