War injuries treated under primitive circumstances: experiences in an Ugandan mission hospital

Due to political instability in many Third World countries doctors in simply equipped rural hospitals are sometimes confronted with war injuries. In those situations sending patients to specialized centres is often impossible. We studied a series of 100 consecutive patients with missile injuries treated during 1982/3 in an Ugandan mission hospital. Out of these 87 were available for sufficient follow-up, 11 disappeared before completing the treatment, and two died. The results are reported. It is concluded that many cases of missile injuries, except the most serious thoraco-abdominal lesions and major neurovascular problems, can be managed satisfactorily in rural hospitals with basic facilities only, provided sound surgical principles are observed, particularly wound treatment in two stages.