Amputees in a hospital of the International Committee of the Red Cross.

The object of this study is to describe the treatment of patients with an amputation in terms of causes and distribution of injuries, mortality and drain on surgical resources. A group of patients with war injuries, who did not undergo an amputation (1796) and a group of war-injured patients with an amputation (245) were analysed retrospectively. All these patients were treated in the hospital for Afghan war wounded of the International Committee of the Red Cross. The most common amputation was below-knee amputation (BKA). In more than 90 per cent of the patients a BKA was the result of a mine explosion. About 80 per cent of amputations of the lower limb were caused by antipersonnel mines. The upper limb amputations were mainly caused by mines or by fragments. War-injured patients with an amputation face more serious problems than non-amputated patients. Their mortality is higher, they stay longer in the hospital, the risk of infection is higher, they need more blood and they undergo more surgical interventions. The high percentage of non-combatants stresses the need to give civilians better protection against the indiscriminate use of mines.