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[Hospital care for war casualties: forward surgery]
Frédéric Rongieras1,2, Antoine Bertani2, Yoann Baudoin3
1Service de chirurgie orthopédique, HIA Desgenettes ; service de chirurgie orthopédique, membre inférieur, hôpital Édouard- Herriot, Lyon, France.
La Revue Du Praticien
|December 5, 2018
Summary
Forward surgery for war casualties prioritizes life, organ, and function preservation through rapid, damage control procedures on the front lines. Definitive treatment is deferred until patients are stabilized, often post-evacuation.
Area of Science:
- Military medicine
- Trauma surgery
- Emergency medicine
Background:
- Modern conflicts result in multiple injuries among war casualties.
- Ballistic protection has reduced fatal trunk injuries.
- Initial surgical management is critical for survival and function.
Purpose of the Study:
- To outline the therapeutic strategy for forward surgery in war casualties.
- To define the priorities of initial surgical interventions.
- To describe the role of damage control surgery in theater.
Main Methods:
- Initial surgical procedures performed on the theater of operations.
- Focus on simple, rapid, and incomplete surgical interventions.
- Application of damage control surgery for specific injuries.
Main Results:
- Forward surgery adheres to priorities: life-saving, organ salvage, and function preservation.
- Damage control surgery is employed for trunk, vascular, and limb lesions.
- Definitive treatment is contingent upon patient resuscitation and stabilization.
Conclusions:
- Forward surgery is a critical component of war casualty care.
- Damage control principles guide initial interventions in austere environments.
- Phased surgical management optimizes outcomes for severely injured combatants.
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