Current concepts in the management of penetrating torso injury

Trauma has been described as a "disease of bleeding" [45]. Recognition of a cute blood loss after injury, and restoration of homeostasis is the corners tone of the initial care of the badly injured patient. Hypovolaemia remains the most common cause of death among those killed in action during militar y conflicts [46] and, in the civilian arena, increasing numbers of patients are being encountered with penetrating injuries, even in societies where b lunt injury have previously been the norm. Increased use of higher calibre weapons or with altered ammunition means some patients will present with ex sanguinations and critical physiological instability. Successful outcomes after the treatment of patients with penetrating trauma depend on the integration of many agencies, from prehospital care, initial reception, assessment and resuscitation through the operating room, intens ive care and post-injury rehabilitation. Recognition of the importance of t ime and adherence to sound trauma management principles with conservative m anagement when appropriate should see further improvements in our treatment of this important group of patients. Reducing the incidence of these injur ies is the responsibility of us all and must be the focus of all government al initiatives.