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- Estimated blood storage requirements for a North Korean invasion of South Korea and South Korea’s preparedness
- Kun Hwang, Chan Yong Park
- J Trauma Inj. 2025;38(3):232-236. Published online September 29, 2025
- DOI: https://doi.org/10.20408/jti.2025.0061
- 3,702 View
- 59 Download
- 1 Citations
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Abstract
PDF - Purpose
Hemorrhage is the leading cause of preventable battlefield deaths, and up to 30% of casualties could survive with timely transfusions. In a potential North Korea–South Korea conflict, ensuring adequate blood supply would be crucial for military medical readiness. This study estimated the 2-week blood demand in such a conflict and evaluated South Korea’s preparedness to meet it.
Methods
A multifaceted approach was employed, incorporating historical casualty data, medical literature on battlefield transfusions, South Korean blood supply reports, and military blood logistics models. Projections indicate 80,000 to 150,000 casualties within the first 2 weeks, with 30% of military and 15% of civilian casualties requiring transfusions. The estimated total blood demand ranges from 360,000 to 600,000 L, surpassing current South Korean reserves.
Results
Despite a 100,000-L prewar storage goal, weekly replenishment needs could reach 150,000 to 300,000 L, placing immense strain on collection, storage, and distribution systems. Key shortages include packed red blood cells, fresh frozen plasma, and platelets, with projected deficits of up to 120,000, 70,000, and 30,000 units, respectively. The logistical challenges of storing and transporting platelets, given their 5-day shelf life, make them particularly vulnerable to depletion. To address these shortages, a multipronged strategy is required, including pre-war stockpiling, mobile blood banks, rapid military-civilian coordination, international cooperation with US and other allies, and prioritization of whole blood over component therapy.
Conclusions
South Korea’s current blood reserves are insufficient for a large-scale war. A combination of strategic stockpiling, military-civilian coordination, and alternative blood sources (synthetic oxygen carriers, prewar autologous donation programs) is essential to sustaining medical operations and improving survival rates. -
Summary
Citations
Citations to this article as recorded by
- Severe trauma care: advances and future directions in diagnostic and therapeutic techniques and information technology support
Feifei Jin, Shu li, Xuemin Zhang, Wei Huang, Jing Zhou, Zhongdi Liu, Pan Hu, Yanqiu Wu, Zixiao Zhang, Lijun Hou, Xiangjun Bai, Tianbing Wang
Medical Review.2026; 6(3): 175. CrossRef
Review Article- Trauma Surgery and War: A Historical Perspective
- Kun Hwang
- J Trauma Inj. 2021;34(4):219-224. Published online September 7, 2021
- DOI: https://doi.org/10.20408/jti.2021.0029
- 13,135 View
- 245 Download
- 3 Citations
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Abstract
PDF
The aim of this review is to introduce the progress in trauma surgery made during war. In the 16th century, Paré reintroduced ligature of arteries, which had been introduced by Celsus and Galen, instead of cauterization during amputation. Larrey, a surgeon in Napoleon’s military, adapted the “flying artillery” to serve as “flying ambulances” for rapid transport of the wounded. He established rules for the triage of war casualties, treating wounded soldiers according to the seriousness of their injuries and the urgency of medical care. To treat fractures and tuberculosis, Thomas created the “Thomas splint”, which was used to stabilize fractured femurs and prevent infection; in World War I (WWI), use of this splint reduced the mortality of compound femur fractures from 87% to less than 8%. During WWI, Cushing systematized the treatment of head injuries, reducing mortality among head injury patients. Gillies repaired facial injuries, and his experiences became the basis of craniofacial and aesthetic surgery. In WWII, McIndoe discovered that immersion in saline promoted burn healing and improved survival rates, and thus began saline baths and early grafting instead of using tannic acid. A high mortality rate in patients with acute renal failure was noted in WWII and the Korean War. In the Korean War, Teschan used the Kolff-Brigham dialyzer. The first use of medevac with helicopters was the evacuation of three British pilot combat casualties by the US Army in Burma during WWII. As a lotus blooms in the mud, military surgeons have contributed to trauma surgery during wartime.
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Summary
Citations
Citations to this article as recorded by- Freud Gradiva and the Aesthetic Unconscious: Lessons for the Plastic Surgeon
Kun Hwang
Journal of Craniofacial Surgery.2026; 37(6): e539. CrossRef - Trauma eponyms (1837–1950): a comprehensive historical review
Halil Tekiner, Eileen S. Yale, Jacob Draves, Steven H. Yale
Journal of Trauma and Injury.2025; 38(3): 168. CrossRef - New horizons of Flaubert: from a barber-surgeon to a modern trauma surgeon
Kun Hwang
Journal of Trauma and Injury.2022; 35(Suppl 1): S1. CrossRef
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