Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, West Wing, Birmingham Research Park, Vincent Drive, Birmingham B5 1SQ, United Kingdom.
Injury. 2010 May;41(5):453-9. doi: 10.1016/j.injury.2009.11.012.
British military forces remain heavily committed on combat operations overseas. UK military operations in Afghanistan (Operation HERRICK) are currently supported by a surgical facility at Camp Bastion, in Helmand Province, in the south of the country. There have been no large published series of surgical workload on Operation HERRICK. The aim of this study is to evaluate this information in order to determine the appropriate skill set for the modern military surgical team.
A retrospective analysis of operating theatre records between 1st May 2006 and 1st May 2008 was performed. Data was collated on a monthly basis and included patient demographics, operation type and time of operation.
During the study period 1668 cases required 2210 procedures. Thirty-two per cent were coalition forces (ISAF), 27% were Afghan security forces (ANSF) and 39% were civilians. Paediatric casualties accounted for 14.7% of all cases. Ninety-three per cent of cases were secondary to battle injury and of these 51.3% were emergencies. The breakdown of procedures, by specialty, was 66% (1463) orthopaedic, 21% (465) general surgery, 6% (139) head and neck, 5% (104) burns surgery and a further 4% (50) non-battle, non-emergency procedures. There was an almost twofold increase in surgical workload in the second year (1103 cases) compared to the first year of the deployment (565 cases, p<0.05).
Surgical workload over the study period has clearly increased markedly since the initial deployment of ISAF forces to Helmand Province. A 6-week deployment to Helmand Province currently provides an equivalent exposure to penetrating trauma as 3 years trauma experience in the UK NHS. The spectrum of injuries seen and the requisite skill set that the military surgeon must possess is outside that usually employed within the NHS. A number of different strategies; including the deployment of trainee specialist registrars to combat hospitals, more focused pre-deployment military surgery training courses, and wet-laboratory work are proposed to prepare for future generations of surgeons operating in conflict environments.
英国军队仍在海外的作战行动中投入大量兵力。英国在阿富汗（Operation HERRICK）的军事行动目前由赫尔曼德省坎普巴斯蒂恩（Camp Bastion）的一个外科设施提供支持。目前还没有关于 HERRICK 行动的大规模外科工作量的出版物。本研究旨在评估这些信息，以确定现代军队外科团队的适当技能组合。
对 2006 年 5 月 1 日至 2008 年 5 月 1 日期间的手术室记录进行了回顾性分析。数据按月收集，包括患者人口统计学、手术类型和手术时间。
在研究期间，1668 例患者需要进行 2210 次手术。32%是联军（ISAF），27%是阿富汗安全部队（ANSF），39%是平民。儿科伤员占所有病例的 14.7%。93%的病例是战斗损伤所致，其中 51.3%是紧急情况。按专业划分的手术程序为：骨科 66%（1463 例）、普通外科 21%（465 例）、头颈部 6%（139 例）、烧伤外科 5%（104 例）和另外 4%（50 例）非战斗性、非紧急手术。与部署的第一年（565 例）相比，第二年（1103 例）的手术工作量几乎增加了一倍（p<0.05）。
自 ISAF 部队最初部署到赫尔曼德省以来，研究期间的外科工作量明显大幅增加。在赫尔曼德省部署 6 周相当于在英国国民保健署（NHS）进行 3 年创伤经验。所看到的损伤谱和军队外科医生必须具备的必要技能组合超出了 NHS 通常采用的范围。为了准备未来在冲突环境中运作的外科医生，提出了一些不同的策略，包括向战斗医院部署实习专科医生、更有针对性的军事外科培训课程以及湿实验室工作。
