Evaluation and Treatment

The most important aspect of evaluation and treatment of war wounds is a high index of suspicion for fungal infection, with the early recognition of unhealthy or suspicious wounds followed by early, aggressive, and repetitive surgical debridement of all devitalized tissue and organic material.

After initial debridement, risk factors for invasive fungal infection will be assessed. Identified risk factors include:

- Dismounted blast injury.
- Above-knee immediate traumatic amputation, or progressive transition from below-knee to through-knee to above-knee amputation.
- Extensive perineal, genitourinary, and/or rectal injury.
- Massive transfusion > 10 units packed red blood cells within 24 hours of injury.
- Extensive deep-partial-thickness or full-thickness burns (note: covered elsewhere).17