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Updated: Jun 14, 2025

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Competency-based vascular surgery training for austere conditions.

Charles J Fox1

  • 1R Adams Cowley Shock Trauma Center, Baltimore, MD; Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.

Surgery
|March 15, 2025
PubMed
Summary
This summary is machine-generated.

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Prompt evaluation and management of penetrating vascular injuries are crucial for military surgical teams. This article outlines essential vascular surgery techniques for austere combat environments, drawing on combat surgeon experiences.

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).

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  • 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.