HAND GRENADE INJURIES AMONG CIVILIANS

Objectives.-To describe how noncombatants are injured by hand grenades in camps for displaced people, and to categorize grenade wounds according to the Red Cross wound classification. Design.-Case series. Setting.-A surgical hospital in Khao I Dang refugee camp on the Thailand-Cambodia border. Patients.-Seventy-four patients injured by hand grenades. Interventions.-Intravenous antibiotics and primary wound surgery. Main Outcome Measures.-Combatant status of the patients, categorization of the wounds, surgical outcome, number of operations, and number of blood transfusions. Results.-Only 7% of the patients sustained their wounds in battle and 50% were women, children, or older men. Seventy had 91 wounds that could be categorized; 59% of the wounds were small, affecting only soft tissue. Few wounds were associated with fractures and none with comminuted fractures. Twenty-four soft-tissue wounds were treated conservatively with minimal morbidity and no mortality. Conclusions.-Missiles (fragments or bullets) from hand grenades tend to produce wounds with little tissue damage. Serious injury is due to penetration of vital structures. The results permit a recommendation that certain small and uncomplicated fragment wounds can be treated initially without surgery.