Updated

A steady stream of American wounded from the Fallujah (search) offensive in Iraqi have been arriving at the U.S. military's main hospital in Europe, prompting staff to expand bed capacity, officials said Thursday.

A planeload with 53 wounded from Iraq, most of them from Fallujah, arrived Thursday morning and another with 49 more was due in later in the day at the Landstuhl Regional Medical Center (search) — totaling 102 for the day, spokeswoman Marie Shaw said.

Two more planeloads of wounded were expected Friday. The newcomers are joining 125 others who arrived during the first three days of the week.

"We are very busy," Shaw said. "We have seen an increase of patient arrivals since the outbreak of the Fallujah conflict."

Landstuhl has long been a destination for seriously wounded but stable troops from combat in Iraq and Afghanistan, and usually treats between 30 and 50 injured military personnel per day, Shaw said.

Lt. Col. Richard Jordan, a physician at the hospital's Deployed Warrior Center (search), which assesses incoming wounded after their six-hour plane trip, said the majority of injuries were "significant, but not major."

"We've had more cases of bullet wounds than usual, though some have also suffered blast wounds from rocket-propelled grenades," he said.

There were several intensive care cases involving brain or spinal injuries or traumatic amputation of limbs, he said. Four such patients were brought in Thursday morning on the first plane and four more are expected from the second plane later Thursday, he said.

The military has reported 13 Americans killed in the Fallujah campaign, which began Monday night with thousands of U.S. Marines and soldiers and Iraqi troops pouring into the city.

Jordan said the Landstuhl staff was coping well with the heavy workload. "We have had some people calling and volunteering to come in from other bases to help out," Jordan said.

He called Thursday "probably one of the busiest days in quite some time," since he began working at the hospital in 2002. "We are on contingency mode, a 60-hour work week," he said.

Two more planeloads of wounded were expected to arrive Friday.

Shaw said the hospital was expanding capacity to cope with the additional numbers of patients. "We have expanded our intensive care unit here with about 10 more beds, and we have expanded our medical surgical wards with about 40 more beds," she said.

The hospital, the largest U.S. military medical facility outside the United States, now has 27 intensive care beds, including the expansion.

It is normally equipped with 162 beds, the hospital's Web site says, with an expansion capability of up to 310 beds. The center also provides specialized care for the more than 250,000 additional American military personnel and their families based in Europe.

All the wounded who have come so far from Fallujah are U.S. soldiers, although Americans are fighting alongside Iraqi forces there.