The Red Cross wound classification was applied to 63 casualties requir
ing surgery in the recent Gulf war, The majority of wounds affect only
soft tissue, caused predominantly by antipersonnel fragments. Bullet
wounds were fewer but tended to be more severe, often involving a frac
ture or vascular damage We recommend minor modification to the classif
ication to include scoring of significant neurological injury. Further
, we feel that by recording the distribution of all wounds as well as
scoring the casualty's two worst injuries, the incidence and pattern o
f multiple wounds are ascertained, which is useful in military surgica
l research. We believe that the Red Cross wound classification is valu
able in assessing a wound as part of a secondary survey, but that this
wound score has little part to play in triage. It may help to decide
management of individual wounds in clinical practice and is useful for
recording the nature of wounds for future analysis.