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BAUMHOLDER, Germany — A U.S. Army report has confirmed what military trauma surgeons in Afghanistan have long suspected: More troops are suffering devastating wounds, including arm, leg and multiple-limb amputations as well as genital injuries, because of bomb blasts.

The uptick is partly due to the increase in foot patrols— a counterinsurgency strategy that gets servicemembers out among the Afghan people. But the tactic leaves troops more vulnerable to roadside bombs, mines and other buried explosives.

So far this year, 147 servicemembers have had an amputation — a number that, should the pace continue, would exceed any year since the war in Afghanistan began, military officials said Tuesday during a Pentagon press conference after releasing the report. There were 86 in 2009, and 187 in 2010.

There have been 77 cases of multiple-limb amputations this year, the most of any year so far. Last year there were 72, and 23 in 2009. Officials said genital injuries also have risen significantly, but did not give specific figures.

What’s more, last year more than 90 percent of the amputations took place at combat hospitals or at Landstuhl Regional Medical Center in Germany, the hub for troops injured downrange.

It’s a sign of just how devastating these injuries are, say military surgeons, who try to perform only crucial operations downrange, preferring to leave amputations until an injured servicemember has returned stateside and has had time to recuperate.

“We do everything we can to salvage a severely injured lower extremity,” said Brig. Gen. Joseph Caravalho Jr., an Army doctor and chairman of the task force that produced the study. But amputation is increasingly seen as the only choice, even in combat settings. Military doctors attribute the rising number of amputations, in part, to more troops surviving injuries that would have killed them earlier in the wars. The study found that the rate of servicemembers killed in action in Afghanistan has gone down steadily since 2006, even after President Barack Obama sent more troops there in 2010.

But the severity of injuries has continued to rise, and the report left little doubt that the counterinsurgency tactic of having troops on foot patrols, rather than riding in armored vehicles, is a contributor. The soldier on foot is at greater risk for severe injuries, the report noted, “and the injury severity (in Afghanistan) confirms this.”

The report, commissioned early this year by the Army surgeon general, Lt. Gen. Eric Schoomaker, made 92 recommendations on how to improve care for severely injured soldiers, such as sending urologists to combat hospitals downrange to improve the outcome for patients with genital injuries.

Some of the Army’s proposals to protect troops from bomb blasts, such as giving troops what have been dubbed “blast boxers,” or Kevlar underwear, have already been implemented. Medics have also started fielding new viselike tourniquets that can be placed over the groin and lower abdomen to stop bleeding in areas where a typical tourniquet will not work. And the Army is training flight medics in critical-care lifesaving skills to treat the most severely wounded, said Caravalho.

Still, he added, for those who have them, “these are lifelong injuries that our warriors will live with for the next 60 years. … We want our warriors to know there is always hope, even after complex traumatic injuries, that military medicine and the VA [Veterans Affairs] will be with them in the long run, and that they are entitled to the absolute best care we can provide.”

The Associated Press contributed to this report.

robbinss@estripes.osd.mil

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