The Victoria bomb: a report from the Westminster Hospital.

On 18 February 1991 a bomb exploded on Victoria station, London. A total of 51 people were injured including one fatally. Of the most seriously wounded, 30 were treated at The Westminster Hospital. The majority of injuries were to the lower limbs, but serious wounds were also sustained to the chest, abdomen, forearm, orbit and cranium. Almost all injuries were caused by shrapnel. The low incidence of infection was attributed to thorough early surgical débridement. The administration of antibiotics was varied and uncoordinated, reflecting a lack of a common policy. The exhaustion of common external fixators necessitated the use of equipment unfamiliar to the surgeons and underlined the need for the rapid transfer of equipment between hospitals at the time of major incidents.