The Red Cross classification of war wounds: the E.X.C.F.V.M. scoring system

The Red Cross classification of war wounds is based upon features of the wound, not upon weaponry. It is proposed as a new means of understanding, communicating, and gathering information about war wounds and their management. The wound score is based on the skin wounds and the presence of a cavity, fracture, vital injury, or metallic bodies in the wound. All wounds so scored can be graded according to severity and typed according to structures injured; consequently, wounds are identified by their clinical significance. A study of 247 wounds shows the feasibility of scoring wounds in the field and yields surgically relevant information about bullet and fragment wounds. The applications of the classification are to wound assessment, establishing a scientific basis to war surgery, surgical audit, and collecting wound data from the field.