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Preface

Contents

Preface

The history of injuries produced by war wounds is in effect the history of surgery. A surgical record of World War II is therefore no innovation except that certain features are now for the first time receiving substantial recognition and treatment. One of these features concerns vascular surgery.

This volume does not purport to be a complete record of casualties with vascular injuries in World War II. Data from many of the theaters of operations are unavailable-notably China-Burma-India, Southwest Pacific, and Pacific Ocean Areas, and records from the North African, Mediterranean, and European theaters are far from complete. Under battle conditions, the existence of vascular injuries was often masked by more extensive injuries to bone and soft tissue. Furthermore, many deaths on the battlefield which might rightfully have been attributable to wounds of the major arteries were not so recorded.

This volume does purport to give a reasonably complete accounting of complications which followed combat-incurred vascular injuries in casualties evacuated to the Zone of Interior. It also includes an accounting of peripheral vascular disorders observed in Army personnel during World War II, with the exception of trenchfoot, immersion foot, and cold injuries, which will be discussed in a separate volume in the Medical History series.

The principles of vascular surgery have been established for many years, and in the interim between World Wars I and II many significant technical advances were made. Vascular injuries, however, are relatively infrequent in civilian life, and few surgeons, even those particularly interested in the subject, had had a large experience with them.

The problem of supplying competent specialized care for the numbers of casualties with these injuries was, therefore, a difficult one. It was solved in World War II by the establishment of three vascular centers to which surgeons experienced in this specialty were attached.

It is to the credit of Surgeon General James C. McGee and his successor, Surgeon General Norman T. Kirk, that these centers were inaugurated soon after the first casualties began to arrive in this country. The chief consultant in surgery, Brigadier General Fred W. Rankin, by his untiring efforts in securing and holding trained personnel and in procuring proper equipment, was responsible in a large measure for the success of this undertaking. In this he had the understanding aid of his assistants, Colonel B. N. Carter, MC, and Colonel Michael E. DeBakey, MC. For the first time in history there was a concentration of clinical material under the supervision of specialists who could carry out concurrently definitive treatment and important phases of clinical investigation. As a result, knowledge regarding the circulatory system has been extended and interest has been generated in a field which, though long recognized, has attracted few workers.

The lessons learned, as reflected in the low mortality rate and the remarkable functional results achieved in these centers, came not by chance but through careful planning and execution. Those who had part in it prayerfully hope that these lessons will not soon be forgotten.

DANIEL C. ELKIN, M. D.
Professor of Surgery

Emory University

Emory University, Ga.
28 May 1954.

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