War Surgery and Medicine
The casualties sustained in the different campaigns are shown in the following tables. These show very clearly the severe effect on our Force of the early battles, associated with the loss of many men as prisoners of war. There was a relatively large number of men who died of wounds in these battles, where forward surgery had to be undertaken under difficult conditions. From Alamein onwards there was a steady improvement in the ratio of ‘died of wounds’ to ‘wounded who recovered’, until the ratio was 1 to 20 in the final battles in Italy, when forward surgery was carried out under the best conditions.
It is difficult to correlate the improvement with any one cause, but the better facilities for the performance of good surgery must have had a marked effect on the results, quite apart from any improved technique and the use of penicillin. It has to be noted that there is a marked difference in the chances of recovery of the wounded man according to whether the army is advancing victoriously or suffering a heavy defeat.
The table of the regional classification of wounds in 2 NZEF covering the greater part of the war shows clearly the relative numbers of the different types of wounds that required treatment. It provides a guide for administrative planning and the provision of specialist surgical teams and equipment and medical supplies, as well as accommodation for the wounded. It shows clearly that the great bulk of the wounded who survive suffer from limb injuries. If a classification could be made of all the wounded (including those killed in action and dying of wounds) it would be found that the proportion of limb injuries would be appreciably lowered, as a much larger proportion of those wounded in the trunk and head die from their wounds, either on the battlefield or later in medical units.page 88
Examination of detailed reports of the deaths in action of 82 New Zealanders in Tunisia reveals that the main injury in each case affected the following regions of the body: head 26, chest 32, abdomen 12, other areas 5, and multiple injuries 7. The series is small, but it can be regarded as fairly typical of the injuries that cause almost immediate death on the battlefield.