It is well recognised that there is a requirement for military surgeons to treat the victims of penetrating trauma while on operations. Casualty templates from recent and past conflicts demonstrate that a high proportion of survivable injuries affect the limbs; expertise in the management of penetrating trauma to the limbs is clearly important. While it is widely agreed that a combined specialities approach to limb injuries is necessary, debate has been ongoing for some time in the UK military as to the most appropriate means to gain the necessary experience for treating the wounds encountered on operations.

This study examines the operational requirement, looking at data and individual cases from Iraq, and considers the relevance of a training placement at The Johannesburg General Hospital, a level 1 trauma centre in South Africa.

Surgeon Lt Cdr Mercer RN is currently a Specialist Registrar in Vascular Surgery at MDHU Portsmouth and Surgeon Lt Cdr Ayers is a Specialist Registrar in Plastic Surgery at Frenchay Hospital in Bristol.