Parker P J
Orthopaedic Department MDHU(N), Friarage Hospital, Northallerton, DL6 1JG.
J R Army Med Corps. 2000 Oct;146(3):199-203. doi: 10.1136/jramc-146-03-09.
246 surgical operations were performed in a UK Field Hospital over an eight month period during Op AGRICOLA in 1999. Whilst there were many injuries caused by military weaponry, non-conflict related injuries were also common. Sixteen laparotomies were performed, nine for mine and gunshot injuries, seven were for 'peacetime' causes. Four extremity external fixators were applied--three after high energy transfer fragment wounds to bone and one after a road traffic accident. One pelvic external fixator was applied. Six limbs were amputated, three in one child. Eight split-skin grafts and three local flaps were performed. Wound debridements (including delayed primary suture), of which half were due to fragment and bullet wounds to non-vital structures, were the most common operation performed. Of the 246 consecutive operations analysed, 91 were performed solely by the orthopaedic surgeon. There were 29 combined cases where one surgeon actively assisted the other. 146 operations were performed on local civilians. A consultant orthopaedic surgeon and a consultant general surgeon along with experienced anaesthetic and operating theatre staff remains the combination best suited to provide medical support to future military operations of this kind.
1999年“AGRICOLLA行动”期间，一家英国战地医院在八个月内实施了246例外科手术。虽然有许多伤势是由军事武器造成的，但与冲突无关的伤势也很常见。实施了16例剖腹手术，其中9例是因地雷和枪伤，7例是“和平时期”的病因。应用了4例肢体外部固定器——3例用于高能转移导致的骨碎片伤口，1例用于道路交通事故后。应用了1例骨盆外部固定器。截肢6例，其中1名儿童截肢3例。实施了8例植皮手术和3例局部皮瓣手术。伤口清创术（包括延期一期缝合）是最常见的手术，其中一半是由于非重要结构的碎片和枪伤。在分析的246例连续手术中，91例仅由骨科医生实施。有29例联合手术，一名外科医生积极协助另一名外科医生。对当地平民实施了146例手术。一名骨科顾问医生、一名普通外科顾问医生以及经验丰富的麻醉和手术室工作人员仍然是最适合为未来此类军事行动提供医疗支持的组合。
