Maitland Laura, Lawton Graham, Baden James, Cubison Tania, Rickard Rory, Kay Alan, Hettiaratchy Shehan
Birmingham, United Kingdom.
From the Academic Department of Military Surgery and Trauma, Department of Military Surgery and Trauma, Royal Centre for Defence Medicine.
Plast Reconstr Surg. 2016 Apr;137(4):717e-724e. doi: 10.1097/PRS.0000000000002020.
Plastic surgery has historically been linked to war. Between 2008 and the end of combat operations in Afghanistan in 2014, British military plastic surgeons formed part of the multinational military surgical team at the Role 3 Medical Treatment Facility, Camp Bastion, Helmand Province. The present study aimed to analyze the activity of these surgeons objectively and to determine the utility of their deployment.
Data were gathered prospectively from four periods (2009 to 2012). This coincided with different surgeons, types of combat activity, wounding patterns, and mission emphases for the hospital. Various metrics were employed.
Plastic surgeons were involved in 40 percent of surgical cases (645 of 1654). This was consistent, despite changes in the predominant wounding mechanism and casualty population. One-third of cases involved the plastic surgeon as the lead or sole surgeon and two-thirds involved working with surgeons from other disciplines. Caseload by anatomical region was as follows: hand and upper limb, 64 percent; head and neck, 46 percent; lower limb, 40 percent; and trunk, 25 percent. A median of 1.75 body areas were operated on per patient. Involvement did not differ between patients wearing combat body armor when injured and those who were not.
Plastic surgeons played a significant role in the management of modern military trauma. This reflects the types of injuries sustained and the expertise of military plastic surgeons complementing the skill set of the other surgical team members. The level of activity was independent of wounding patterns, suggesting that the specialty may be useful, irrespective of the nature of the conflict.
整形手术在历史上一直与战争相关。2008年至2014年阿富汗作战行动结束期间，英国军事整形外科医生是位于赫尔曼德省巴斯蒂安营地的3级医疗设施中多国军事外科团队的一部分。本研究旨在客观分析这些外科医生的工作情况，并确定他们部署的效用。
前瞻性收集了四个时期（2009年至2012年）的数据。这与不同的外科医生、战斗活动类型、受伤模式以及医院的任务重点相吻合。采用了各种指标。
整形外科医生参与了40%的外科病例（1654例中的645例）。尽管主要受伤机制和伤亡人群有所变化，但这一比例保持一致。三分之一的病例中，整形外科医生是主刀或唯一的外科医生，三分之二的病例中他们与其他学科的外科医生合作。按解剖区域划分的病例数量如下：手和上肢，64%；头和颈，46%；下肢，40%；躯干，25%。每位患者接受手术的身体部位中位数为1.75个。受伤时穿着战斗防弹衣的患者和未穿的患者之间，整形外科医生的参与情况没有差异。
整形外科医生在现代军事创伤的治疗中发挥了重要作用。这反映了所受损伤的类型以及军事整形外科医生的专业知识对其他外科团队成员技能的补充。活动水平与受伤模式无关，这表明无论冲突的性质如何，该专业可能都很有用。
