Abstract

Introduction: Acquiring and maintaining a wide range of surgical skills is challenging both for military surgeons and all physicians providing surgical treatment in a wartime conflict. In the article we analyze the activities of the surgeons of the field surgical team of the Army of the Czech Republic operating in the multinational hospital ROLE 3 in Kabul, Afghanistan, in the International Security and Assistance Force (ISAF) operation. Methods: All patients undergoing surgery between 21st June and 26th September 2012 were evaluated. ISAF soldiers, Afghan Army soldiers, Afghan National Police officers, Afghan civilians and non-Afghan civilians of various nationalities were operated on including children. Combat and noncombat injuries and illnesses requiring acute surgical treatment or elective surgery were monitored. Results: In a period of three months, a total of 442 procedures were performed on 263 patients, 23% of whom were pediatric patients with the mean age of 10 years. Thirty seven percent were operated on due to a combat injury, 29% were operated on due to a non-combat injury, and 34% of the patients were operated on due to a chronic or acute illness. In combat injuries, 57% were combined injuries requiring a solution based on the principle of damage control surgery, and 26% required life-saving procedures for injuries to the chest and large vessels. Conclusion: A military surgeon, as well as a surgeon treating wounds in a war conflict, must have extensive professional knowledge and must master a wide variety of surgical skills to quickly and effectively deal with especially life-threatening conditions, including thoracic and vascular trauma. In contrast to the direction of current surgery towards specializations and sub-specializations, it seems necessary to develop and implement in the Czech Republic a comprehensive surgical training program focusing on war injuries.

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