Place Ronald J, Rush Robert M, Arrington Edward D
250th Forward Surgical Team (Airborne), Combined Joint Special Operation Task Force-South, Kandahar, Afghanistan.
Curr Surg. 2003 Jul-Aug;60(4):418-22. doi: 10.1016/S0149-7944(02)00718-3.
Forward Surgical Teams (FST) deploy to support conventional combat units of at least regimental size. This report examines the injuries and treatments of an FST in an environment of unconventional tactics, limited personal protection, and extended areas of responsibility during Operation ENDURING FREEDOM.
A prospective evaluation of the personal protective measures, mechanisms of injury, types of injuries, and times to treatment in Operation ENDURING FREEDOM. Additionally, per-surgeon caseloads, operative interventions, and outcomes are examined. The first phase of this deployment involved co-locating with an Air Force Expeditionary Medical Squadron at Seeb Air Base, Oman (SABO). The second phase involved stand-alone operations at Kandahar International Airport (KIA). Participants include U.S. Special Forces, conventional U.S forces, coalition country special forces, and anti-Taliban Afghan soldiers.
During the deployment, the FST performed 68 surgical procedures on 50 patients (19 SAB, 31 KIA). There were 35 orthopedic cases (2 to 28 per surgeon), 30 general surgery cases (2 to 10 per surgeon), and 3 head/neck cases. Mechanism of injury included non-battle injury (13), bomb blast (13), gunshot wounds (8), mine (8), and grenades (5). Primary injuries were to the extremities in 27, torso in 9, and head/neck in 11. Three patients had appendicitis. Five patients were wearing body armor, whereas 4 wore helmets. The mean Relative Trauma Score was 7.4. Thirty-one patients were treated at KIA with a mean time to operative treatment of 2.7 +/- 2.7 hours, whereas 19 were treated in SABO with a mean time to operative treatment of 12.4 +/- 15.1 hours. Nine patients received transfusions. Three nonoperative patients died of wounds.
Despite the lack of personal protective gear, most patients had extremity wounds as their primary injuries. In this special operations environment, time to operative treatment was significantly longer than expected.
前方外科手术队（FST）进行部署以支援至少团级规模的常规作战部队。本报告研究了持久自由行动期间，在非常规战术、个人防护有限以及责任区域扩大的环境下，一支前方外科手术队的伤员情况及治疗情况。
对持久自由行动中的个人防护措施、受伤机制、损伤类型及治疗时间进行前瞻性评估。此外，还对每位外科医生的病例数量、手术干预措施及治疗结果进行了研究。此次部署的第一阶段是与阿曼塞卜空军基地（SABO）的空军远征医疗队合驻。第二阶段是在坎大哈国际机场（KIA）独立开展行动。参与人员包括美国特种部队、美国常规部队、盟国特种部队以及反塔利班的阿富汗士兵。
在部署期间，前方外科手术队对50名患者实施了68例外科手术（19例在SABO，31例在KIA）。其中有35例骨科病例（每位外科医生2至28例），30例普通外科病例（每位外科医生2至10例），以及3例头颈部病例。受伤机制包括非战斗伤（13例）、炸弹爆炸伤（13例）、枪伤（8例）、地雷伤（8例）和手榴弹伤（5例）。主要损伤部位为四肢的有27例，躯干的有9例，头颈部的有11例。3例患者患有阑尾炎。5名患者穿着防弹衣，4名患者戴着头盔。平均相对创伤评分是7.4。31例患者在KIA接受治疗，手术治疗的平均时间为2.7±2.7小时，而19例在SABO接受治疗，手术治疗的平均时间为12.4±15.1小时。9名患者接受了输血治疗。3例非手术治疗的患者因伤死亡。
尽管缺乏个人防护装备，但大多数患者的主要损伤部位为四肢创伤。在这种特种作战环境下，手术治疗时间比预期显著延长。
