Plastic Surgery at War: A Scoping Review of Current Conflicts

Area of Science:

• Military Medicine
• Plastic Surgery
• Surgical Outcomes

Background:

• The role and practice locations of military plastic surgery have evolved significantly with wartime demands.
• Understanding past contributions is essential for optimizing plastic surgeon deployment in future conflicts.

Purpose of the Study:

• To characterize the contributions of plastic surgeons in recent military operations.
• To inform future utilization strategies for military plastic surgeons.

Main Methods:

• A scoping review of military plastic surgery literature published post-September 1, 2001.
• Systematic screening of articles for relevance and data extraction on care provided and operational level.

Main Results:

• Fifty-five studies were included, primarily retrospective cohort studies from the US (2005-2019).
• Key areas of care included extremity reconstruction (40%), general wound management (36.4%), and craniofacial surgery (16.4%).
• Microsurgical reconstruction was prominent; care was delivered at Role 3 and Roles 4/5 facilities, with distinct approaches at each level.

Conclusions:

• Plastic surgeons are indispensable for managing complex combat injuries, including extremity reconstruction and craniofacial trauma.
• Maintaining specialized surgical skills within the military is critical for effective management of wounded service members.
• Lessons learned highlight the need for continued evaluation of skill maintenance strategies.