The Medical Frontlines Of War

They are the wounded who survive, living, breathing testaments to 21st century military medicine, who work on the front lines of ground-breaking advancements, giving America's wounded a chance of survival like never before in warfare.

"This is a historic achievement. We've now saved more than 90 percent of the soldiers who were hit in the battlefield and how they accomplished that, how they got there is important for lessons throughout medicine about what we can do, Dr. Atul Gawande tells CBS News correspondent Randall Pinkston.

Gawande is a researcher at the Harvard School of Public Health.

The difference between today's survival rate to those of war's past is staggering.

"You go back to the Revolutionary War and 42 percent of those soldiers who were hit in battle died," Gawande says. "By World War II, it was under 30 percent who had died from their wounds. And, yet, by the Korean War, Vietnam War and even the Persian Gulf War, it was around 25 percent who died.

"We didn't make a massive improvement and, yet, in this war we have."

The difference, Gawande discovered, was described in a 2004 issue of the New England Journal of Medicine accompanied by rare pictures taken by military doctors.

It has required some changes in the protocol of surgery.

"It is a completely different way of thinking. It's called damage control surgery," Gawande says. "We're used to surgeons taking care of the person from beginning to end by ourselves."

The goal is to save lives by doing only what is necessary, then sending the wounded on to the next link of the military's medical care network: from the medic on site to surgical units to combat field hospitals to "critical care" aircraft to Germany and then home.

"At the very beginning of the war, surgeons didn't trust the idea that they needed to just do an operation for two hours and then perhaps leave the wound open. They may not have stitched all the bowel together. They have packed off the bleeding, but they haven't sewn up every vessel. And, yet, I'm gonna pull a still drape over them, leave them on the ventilator, tack a note on saying, 'Please finish' and send them to Baghdad," Gawande explains.

"Shipping them to Landstuhl (in Germany) and then back to the United States, while they're still critically ill and on ventilators and in need of further surgeries, that -- that was unheard of until this war," says Colonel Craig Shriver, who teaches battlefield surgery at the Walter Reed Army Medical Center.

To appreciate the speed, consider this: during the Vietnam war, it took 45 days for the wounded to go from battlefield to stateside.

Today, it takes less than four.

Shriver explains that improvements in transporting patients by air such as modified ventilators, IV drips and improved staff on board have led to the quick turnaround.

But, Shriver says innovation isn't just happening out in the field. Doctors from Baghdad to Landstuhl to stateside are constantly communicating and collaborating like never before.

"We're giving each other these lessons and feedback on a constant basis so that we can learn, even during the war. We're not gonna wait for the war to be over to learn the lessons," Shriver says.

For instance, Shriver says, "I remember, years ago, watching patients die from this problem on their abdomen of, called intra-abdominal hypertension, where we didn't understand why their abdomens were swelling up and blood pressure was going down."

The solution: an innovative surgical technique allowing some wounds to remain open -- sealed off by Gortex.

"You must leave it open otherwise the tension within the abdomen goes too high and cuts off the blood flow to the heart," Shriver explains.

The technique is now being used in civilian hospitals, just the latest example of medical advances on the front lines making their way to the home front and the general public.

"I believe that necessity is the mother of invention. And as you would probably agree, war provides many necessities," says Dr. Larry Loughlin, dean of the Uniformed Services University.

Prior to the Civil War, Loughlin says, "The concept of the hospital as we know it did not exist."

During World War I, the idea of bringing blood to the battlefield for blood transfusions was introduced. World War II marked the first widespread use of penicillin and after debuting during the Korean war, emergency evacuation helicopters became a common feature of medicine's battle plan during Vietnam.

Shriver says the correlation between advances in emergency care and war stems from the fact that war is "an intense American experience where really the best minds of health care are all coming together for a cause."

He adds, "And so we're putting the best people -- a lot of them together on a specific issue -- and good things come out of that."