Annie McGuinness, clinical director of University College Hospital (UCH) in central London, which treated 15 of the 81 casualties, said: "Some victims have lost limbs or part of limbs. One man has had his leg amputated. The injuries were consistent with a blast, burns and wounds, and in addition we found some nails. There were nails in the wounds."
Several London hospitals brought pre-planned major incident procedures into operation to deal with the bombing, calling in off-duty staff.
The NHS said there were 21 injured at St Thomas', of whom two were critical, 20 at Guy's, all minor cases, 15 at UCH, of whom three were critical, and four at the Royal London, all minor.
Ms McGuinness, likened the injuries to those she had treated while she was working in Northern Ireland. "I was in Belfast during the 1970s and part of the 1980s and I am perhaps more familiar with these types of injuries. It just brought back recollections of Northern Ireland but it is quite appalling wherever it happens."
Of the 15 patients - 11 men and four women - seven suffered serious injuries. Ms McGuinness said five had serious burns of between 25 and 50 per cent - some of which were burns to the face. Two were still in intensive care last night in a critical condition with multiple injuries.
She said more than two people had been operated on during yesterday evening. Some of the operations had been very lengthy and complicated, she said. She said at least two people had had all or part of their leg amputated.
Ms McGuinness said: "A lot of staff, including anaesthetists, physicians and psychiatrists, have come in to look after the people."
Dr Chris Lacy, a consultant at the accident and emergency unit at St Thomas' Hospital, said 26 victims had been admitted to the hospital, two of whom were critically injured and four of whom were seriously injured.
She said: "There are a number of patients in the theatre. Their injuries are consistent with blast injuries. We found two nails underneath patients."
Dr Lacy said that four to six victims had received injuries that were limb-threatening and that one patient had been transferred to a specialist burns unit at Queen Mary's Hospital in Roehampton. She added: "This seems more serious than the cases we received after the Brixton bomb... It's a bit like throwing shards of glass with force at something extremely soft." She said that the accident and emergency unit was emptied of its patients, who were sent to other wards when victims started to arrive at the hospital.
The first paramedic on the scene spoke of the horror of the blast and said the pub looked like a "demolition site".
Motorcycle paramedic Ken Murphy was at the scene in four minutes and found a lot of casualties outside the building and five or six inside. He said they were mainly men aged 20 to 30 with serious flash burns and limbs blown off. He said: "There was a lot of moaning, a lot of people shouting at me to give them oxygen or whatever."
He said paramedics concentrated on working as a team and getting the most seriously injured away from the scene as soon as possible.
Asked what he could see when he went into the pub, the 35-year-old said: "It was just like it was a demolition site."
Mr Murphy said he had seen a lot of burnt debris and glass. He said: "There were bits of wood, the ceiling had come down partially, no lights at all.
"People were moaning and groaning, lots of blood, limbs amputated, what you would expect when a bomb goes off."
After a quick head count he said there were five people inside, and one beyond his help.Reuse content