Peripheral extremity surgery performed during the Syrian conflict - A scoping review

Area of Science:

• Medical Sciences
• Public Health
• Conflict Medicine

Background:

• The Syrian conflict has critically damaged healthcare infrastructure, affecting both conflict and non-conflict surgical needs.
• Peripheral limb surgery provision has been significantly challenged by the ongoing conflict.

Purpose of the Study:

• To review and summarize literature on peripheral limb surgery in Syria (March 2011-January 2024).
• To assess the conflict's influence on surgical capacity and provision for limb injuries.

Main Methods:

• Systematic review following PRISMA-ScR guidelines.
• Searched six academic and one grey literature database.
• Included studies with clinical-epidemiological data on orthopaedic, vascular, and plastic surgery procedures.

Main Results:

• Analyzed 7 studies (total 7749 cases) focusing on orthopaedic, vascular, and plastic surgery.
• Common procedures included wound management (51%), external fixation (26%), and lower limb amputation (15%).
• Prevalence of emergency over elective surgery in rudimentary field hospitals with undertrained staff.

Conclusions:

• Conflict necessitates emergency surgery, but resource scarcity challenges basic care delivery.
• Inadequate data capture due to conflict limits comprehensive surgical datasets.
• Further research is crucial to understand current surgical status, training needs, and care quality.