Cluster bomb vs. antipersonnel mine related injuries. An experience from the Kuwaiti-Iraqi border from June 1998 to November 2000

BACKGROUND: During the last decade cluster bombs containing submunition bomblets (SB) have appeared on battlefields resulting in a new challenge to war surgery. METHODS: Thirty-two patients either wounded by antipersonnel landmines (AP) or SB were treated in a field hospital. The patterns of injuries were described by applying the scoring system of the International Committee of the Red Cross and by Gustilo's classification of open fractures. RESULTS: A total of 95 wounds were observed; 72 caused by SB, 23 by AP. Mortality rate (MR) for the SB group was 6/24 (25.0%), for the AP group 2/8 (25.0%). Three SB patients (12.5%) were "killed in action", leading to a MR of victims "died of wounds" of 3/24 (12.5%) in the SB group and a total MR of 5/32 (15.6%). CONCLUSIONS: From devastating lower limb injuries of AP, a change to multiple wounds affecting the whole body caused by SB has been observed.