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Our daughter is at the Walter Reed Hospital facing some serious leg injuries from an IED. What should we brace ourselves for in the next few weeks to months?

One of the biggest challenges soldiers face when wounded on the battlefield is infection. Explosives of any kind but especially the improvised explosive devices (IEDs) causing so much trouble for our U.S. soldiers in Iraq create a high-energy injury. IED injuries penetrate the skin, muscle, and other soft tissues, leaving a gaping wound and that is open to the elements (dirt, debris). If the bone is broken and the skin laid open (very common), the wound is at risk for tissue contamination. She's in good hands because the surgeons from Walter Reed Army Medical Center are very much at the forefront of developing diagnostic guidelines and medical/surgical treatment protocols for war wounds of this type. Treatment does depend on an accurate diagnosis and gathering as much information as possible about the amount of bone loss, edema or swelling, and the presence of bone abscess. X-rays, MRIs, and other imaging studies are very helpful. Blood tests will be done to assess the amount of immune system response and the presence of bacteria or fungi in the tissues or fluids. The careful use of antibiotics along with débridement (irrigating and cleaning out the wound) and reconstruction may be a part of her medical management. The rehab team of physical and occupational therapists will help her get back on her feet and recover motion, strength, and function. Depending on the severity of her injuries, the treatment from start to finish can take weeks to months to years.

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