Advances allow many more US soldiers to keep limbs

By Adam Tanner

SAN FRANCISCO (Reuters) - A 2004 shooting and roadside bomb injury in Iraq left U.S. Marine Sgt. Oscar Canon, 25, with a gaping hole in his thigh the size of a baseball -- a wound should have cost him his leg. Yet today he can walk and run again.

"In previous wars, this patient would have undergone an amputation," said Dr. Amy Wandel, a plastic surgeon who operated on Canon at the U.S. Navy Medical Center in San Diego.

Wandel, who has treated hundreds of wounded American soldiers, said the amputation rate in the Iraq conflict is just 20 percent compared to 76 percent during the Vietnam War, translating into thousands of saved limbs.

At the annual conference of the American Society of Plastic Surgeons on Monday, Wandel showed off graphic before-and-after photos of Canon's wounds and those of other patients.

Faster treatment and evacuation as well as new plastic surgery techniques "have allowed us to care for injuries that in previous wars would have resulted in the death of the patient or an amputation in the field," said Wandel, who has just retired from the Navy.

"The biggest difference is that during the Vietnam and Korean wars, those injuries resulted in the amputation because we did not have the technology we have to reconstruct nerves, arteries and veins, and then close huge soft tissue wounds in order to have bone healing and functional return," she said.

"All of the work that we are now doing in the military will be able to translate into the civilian world to improve our care for patients, including from motor vehicle accidents," she added.

'THIS IS NOT GOOD'

Wearing his military decorations at a news conference, Canon said he did not realize how seriously he had been hurt until he could no longer stand up.

"I had holes about this big in my thigh," he said, making a circle with his two index fingers and thumbs. "Lying there I just saw my femur. I thought, this is not good."

The recovery process was grueling, and he has undergone 58 surgeries since then.

"A lot of people don't realize that plastic surgery has such a big impact," he said.

Marine Sgt. Douglas Hayenga, 23, who appeared at a news conference with Canon, has undergone nearly two dozen surgeries that included installing a plate as long as his tibia and a subsequent bone graft. He walks with a cane, but no more surgery is planned for now.

Military doctors say most of the U.S. injuries in Iraq are from explosive devices and shrapnel, with legs and arms especially vulnerable because they are not shielded by body armor.

According to the Pentagon, 20,687 in the U.S. military have been wounded in Iraq as of Oct. 6, with 9,352 injured too seriously to quickly return to duty.