[How much competence in emergency vascular surgery does a modern trauma surgeon need?: experiences regarding deployment as a military surgeon].

Management of combat-related major vascular injuries is a challenge to all surgeons and a vascular specialist will not always be available in a wartime setting; therefore, every surgeon deployed to a war setting must be able to cope with these life and limb-threatening injuries. Data obtained from searching Medline and Google on the localization and treatment of combat-related vascular injuries of the USA strike forces in Afghanistan and Iraq were analyzed and adjusted to the requirements of the German Armed Forces. A total of 5-7% of casualties sustained major vascular injuries. After initial treatment using damage control measures to control the bleeding and restore perfusion definitive repair with vascular reconstruction must be performed in a facility with a higher level of care. Basic vascular surgical techniques which all military surgeons need to know are presented taking the austere conditions of a wartime environment into consideration. Preparation of all surgeons for deployment to a wartime situation must include basic knowledge and skills in vascular surgery including emergency and vascular reconstruction techniques.