Barbier Olivier, Malgras Brice, Choufani Camille, Bouchard Antoine, Ollat Didier, Versier Gilbert
From the Surgery Department (O.B., B.M., C.C., A.B., D.O., G.V.), Bégin Military Teaching Hospital, Saint Mandé, France.
J Trauma Acute Care Surg. 2017 Jun;82(6):1122-1128. doi: 10.1097/TA.0000000000001461.
Recent conflicts have allowed the French Army Health Service to improve management quality for wartime-injured people during military operations. On November 13, 2015, it was in Paris that France was directly attacked and Bégin Military Teaching Hospital, like several hospitals in Paris, had to face a large number of gunshot victims. Thanks to our operational experience, injured people hospitalized in military hospitals benefited from a management based on triage and damage control (DC) principles.
Forty-five patients were taken care of in our hospital with an average age of 32 years. During triage, eight patients were categorized T1 (with four extreme emergencies) and 10 were classified T2 and 27 as T3. Twenty-two patients underwent emergency surgery, 15 for soft tissue lesions of limbs, 8 for ballistic fractures (one of which was a cervical wound), and 5 for abdominal wounds. Two patients classified T1 died early.
In total, more than 50 operations were performed including iterative debridements, bone fixation, three amputations, and two flaps. After 9 months, all of the patients had healed. One woman with limb stiffness required an arthrolysis.
This event showed that terrorist attacks and mass casualties with war wounds can occur in France. Acquired experience regarding war wounds by the French Army Health Service is precious. Everyone must understand the importance of triage and the principles of damage control. Every hospital must be ready to face this type of massive influx of injured people (white plan).
Epidemiological study, level V.
近期的冲突使法国军队卫生服务部门能够提高军事行动期间战时伤员的管理质量。2015年11月13日，法国在巴黎遭到直接袭击，贝金军事教学医院和巴黎的几家医院一样，不得不面对大量枪伤患者。得益于我们的作战经验，在军事医院住院的伤员受益于基于分诊和损伤控制（DC）原则的管理。
我们医院共照料了45名患者，平均年龄为32岁。在分诊过程中，8名患者被归类为T1（其中4例为极端紧急情况），10名被归类为T2，27名被归类为T3。22名患者接受了急诊手术，15例为四肢软组织损伤，8例为弹道骨折（其中1例为颈部伤口），5例为腹部伤口。两名被归类为T1的患者早期死亡。
总共进行了50多次手术，包括反复清创、骨固定、3次截肢和2次皮瓣手术。9个月后，所有患者均已痊愈。一名肢体僵硬的女性需要进行关节松解术。
这一事件表明法国可能发生恐怖袭击和伴有战伤的大规模伤亡情况。法国军队卫生服务部门获得的战伤经验非常宝贵。每个人都必须理解分诊的重要性和损伤控制原则。每家医院都必须做好准备应对此类大量伤员涌入的情况（白色预案）。
流行病学研究，V级。
