Competency-based vascular surgery training for austere conditions

Area of Science:

• Vascular Surgery
• Combat Medicine
• Trauma Surgery

Background:

• Penetrating vascular injuries pose significant challenges in military operations.
• Advancements in combat casualty care have improved survival rates and reduced amputations.
• Near-peer conflicts may present new challenges to surgical care delivery on the battlefield.

Purpose of the Study:

• To outline essential vascular surgery principles for austere combat environments.
• To provide guidance based on experiences from recent conflicts.
• To prepare surgical teams for potential challenges in modern warfare.

Main Methods:

• Drawing on experiences of veteran surgeons from the Global War on Terrorism.
• Incorporating insights from non-governmental organizations operating in conflict zones (Iraq, Ukraine).
• Reviewing advancements in combat casualty care since the Vietnam War.

Main Results:

• Modern warfare has seen significant improvements in survival rates (>92%) and reduced amputation rates for vascular injuries.
• Key advancements include prehospital tourniquets, damage control resuscitation, arterial balloon occlusion, and improved diagnostic imaging.
• Austere environments require specific considerations for vascular surgical management.

Conclusions:

• Competent vascular surgery in austere environments is achievable with proper preparation and knowledge.
• Surgical teams must adapt to the unique demands of combat zones.
• Preparedness is key to managing penetrating vascular injuries effectively in future conflicts.