88th Surgical Operations Squadron, Wright Patterson Medical Center, Wright Patterson AFB, OH, 45433, USA.
Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
Mil Med. 2021 Jan 30;186(3-4):e327-e335. doi: 10.1093/milmed/usaa361.
The scope of military plastic surgery and location where care is provided has evolved with each major conflict. To help inform plastic surgeon utilization in future conflicts, we conducted a review of military plastic surgery-related studies to characterize plastic surgeon contributions during recent military operations.
Using a scoping review design, we searched electronic databases to identify articles published since September 1, 2001 related to military plastic surgery according to a defined search criterion. Next, we screened all abstracts for appropriateness based on pre-established inclusion/exclusion criteria. Finally, we reviewed the remaining full-text articles to describe the nature of care provided and the operational level at which care was delivered.
The final sample included 55 studies with most originating in the United States (54.5%) between 2005 and 2019 and were either retrospective cohort studies (81.8%) or case series (10.9%). The breadth of care included management of significant upper/lower extremity injuries (40%), general reconstructive and wound care (36.4%), and craniofacial surgery (16.4%). Microsurgical reconstruction was a primary focus in 40.0% of published articles. When specified, most care was described at Role 3 (25.5%) or Roles 4/5 facilities (62.8%) with temporizing measures more common at Role 3 and definite reconstruction at Roles 4/5. Several lessons learned were identified that held commonality across plastic surgery domain.
Plastic surgeons continue to play a critical role in the management of wounded service members, particularly for complex extremity reconstruction, craniofacial trauma, and general expertise on wound management. Future efforts should evaluate mechanisms to maintain these skill sets among military plastic surgeons.
军事整形手术的范围和提供护理的地点随着每一次重大冲突而演变。为了帮助告知未来冲突中整形医生的利用，我们对军事整形手术相关研究进行了回顾，以描述最近军事行动中整形医生的贡献。
采用范围综述设计，我们根据既定的搜索标准，搜索电子数据库以确定自 2001 年 9 月 1 日以来发表的与军事整形手术相关的文章。接下来，我们根据预先确定的纳入/排除标准筛选所有摘要以确定其是否合适。最后，我们审查了其余的全文文章，以描述所提供的护理性质和提供护理的操作级别。
最终样本包括 55 项研究，其中大部分（54.5%）来自 2005 年至 2019 年，并且是回顾性队列研究（81.8%）或病例系列（10.9%）。护理范围广泛，包括上肢/下肢重大损伤的管理（40%）、一般重建和伤口护理（36.4%）以及颅面手术（16.4%）。显微重建是 40.0%已发表文章的主要关注点。如果有具体说明，大多数护理在第 3 级（25.5%）或第 4/5 级（62.8%）设施中进行，第 3 级更常见临时措施，第 4/5 级进行确定性重建。确定了一些在整形手术领域具有共性的经验教训。
整形医生继续在伤员服务人员的管理中发挥关键作用，特别是在复杂的四肢重建、颅面创伤和伤口管理的一般专业知识方面。未来的工作应评估在军事整形医生中维持这些技能的机制。
