Lessons Learned in the Management of Casualties with Genitourinary System Injuries

• increased frequency of high-velocity weapon wounds, which produce greater tissue destruction than the more-frequently seen low-velocity wounds, which are the ones seen in the civilian community; • increased frequency of multiple fragment wounds (from artillery and mortar shells, bombs, booby traps, land mines); • evacuation of casualties from the combat zone to multiple medical treatment facilities (MTFs) outside the theater of action—even to the continental United States—which precludes continuity of care by the same surgeon and house staff throughout all the phases of wound care; and • greater incidence of mass casualties with high-velocity wounds in combat hospitals.