An Analysis of Head and Neck Surgical Workload During Recent Combat Operations From 2002 to 2016

Area of Science:

• Military Medicine
• Surgical Workload Analysis
• Trauma Surgery

Background:

• Head and neck (H&N) injuries affect a significant percentage of U.S. service members in deployed settings (29%) and during evacuation (21%).
• Understanding the H&N surgical workload is crucial for optimizing medical readiness and resource allocation in military healthcare.

Purpose of the Study:

• To analyze the scope and nature of head and neck (H&N) surgical procedures performed at deployed U.S. military facilities in Iraq and Afghanistan.
• To provide data for informing training requirements, necessary proficiencies, and medical treatment facility (MTF) manning for H&N surgical care.

Main Methods:

• Retrospective analysis of the Department of Defense (DoD) Trauma Registry from January 2002 to May 2016.
• Inclusion of data from Role 2 and Role 3 Medical Treatment Facilities (MTFs).
• Stratification of 385 identified H&N surgical procedure codes into eight categories, excluding traumatic brain and neck vascular injuries.

Main Results:

• A total of 15,620 H&N surgical procedures were identified, with 94.14% performed at Role 3 MTFs.
• Facial bone procedures were the most common (75.03%), followed by tracheostomy (16.67%), eyelid/eyebrow laceration repair (8.23%), and neck exploration (7.41%).
• The H&N surgical caseload exhibited variability across the study period and locations.

Conclusions:

• H&N procedures constituted 8.25% of all surgeries at Role 2 and 3 MTFs, with eye (40.54%) and airway (18.50%) procedures being the most prevalent.
• The findings serve as critical planning tools for determining medical footprint and sustaining training for deployed surgeons.
• This data is particularly relevant for future contingency operations facing resource and personnel constraints.