The history of injuriesproduced by war wounds is in effect the history of surgery. A surgicalrecord of World War II is therefore no innovation except that certainfeatures are now for thefirst time receiving substantial recognition and treatment. One ofthese features concernsvascular surgery.
This volume does notpurport to be a complete record of casualties with vascular injuries inWorld War II. Data from many of the theaters of operations areunavailable-notably China-Burma-India, Southwest Pacific, and PacificOcean Areas, and records from the North African,Mediterranean, and European theaters are far from complete. Underbattle conditions, theexistence of vascular injuries was often masked by more extensiveinjuries to bone and softtissue. Furthermore, many deaths on the battlefield which mightrightfully have been attributableto 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 ofvascular surgery have been established for many years, and in theinterimbetween World Wars I and II many significant technical advances weremade. Vascular injuries,however, are relatively infrequent in civilian life, and few surgeons,even those particularlyinterested in the subject, had had a large experience with them.
The problem of supplyingcompetent specialized care for the numbers of casualties with theseinjuries was, therefore, a difficult one. It was solved in World War IIby the establishment ofthree vascular centers to which surgeons experienced in this specialtywere 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, asreflected in the low mortality rate and the remarkable functionalresultsachieved in these centers, came not by chance but through carefulplanning and execution. Thosewho had part in it prayerfully hope that these lessons will not soon beforgotten.
DANIEL C. ELKIN, M. D.
Professor of Surgery
Emory University, Ga.
28 May 1954.