The Basic and Clinical Science of Wounds in the Austere Environment

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Surgery in developing countries is challenging on many levels. U.S. organizations sponsor approximately 200,000 surgeries performed abroad every year (Miclau et al. 2021a). These altruistic surgeons and physicians– despite their good intentions—may not be equipped with the specific surgical and communication skills necessary for a successful surgery in an austere environment. Surgical skill set, nutrition, facilities, and sociology all play a role in successful surgical outcomes. A thorough understanding of the basic science and clinical science of wounds in the austere environment is imperative for physicians and surgeons providing care in developing nations. Basic science research, in regards to nutrition, parasites; skin, dermal, and bone physiology; as well as microbiome interaction with these structures, can help optimize surgical outcome and reduce adverse events such as infection. Clinical science research and the development of algorithms for surgery in the austere environment can also help improve surgical outcomes and mitigate these adverse events.