Clinical utilization of deployed military surgeons

Area of Science:

• Military medicine
• Surgical outcomes
• Global health security

Background:

• Combat casualty care has evolved due to prolonged conflicts in Southwest Asia.
• Surgeon utilization in austere locations outside Southwest Asia and its impact on skill retention remain understudied.
• This study investigates surgeon utilization in the African theater, hypothesizing low activity levels.

Purpose of the Study:

• To examine surgeon utilization in the African theater.
• To assess the implications of low surgical activity on skill retention and patient care.
• To inform strategies for maintaining surgical readiness.

Main Methods:

• Analysis of military surgeon case logs in Africa (Jan 2016-Jan 2020) under Special Operations Command Africa.
• Cases categorized by population served, procedure type, CPT codes, and location.
• Comparison of surgical activity between East and West African deployments.

Main Results:

• 101 operations performed over 3,294 days across 20 analyzed deployments.
• East Africa averaged 4.1 operations/deployment; West Africa averaged 7.3 operations/deployment.
• West Africa showed a higher proportion of elective and humanitarian cases, while East Africa had more combat/terrorism-related injuries.

Conclusions:

• Surgical case volume for military surgeons in Africa is low.
• Low surgical activity negatively impacts skill retention, morale, and military surgical end strength.
• Recommendations include reducing deployment lengths, adjusting locations, and implementing skill retention strategies to ensure operational readiness.