Accession Number : ADA614693


Title :   Microvascular Reconstructive Surgery in Operations Iraqi and Enduring Freedom: the US Military Experience Performing Free Flaps in a Combat Zone


Descriptive Note : Journal article


Corporate Author : ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX


Personal Author(s) : Klem, Christopher ; Sniezek, Joseph C ; Moore, Brian ; Davis, Michael R ; Coppit, George ; Schmalbach, Cecelia


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a614693.pdf


Report Date : Jan 2013


Pagination or Media Count : 6


Abstract : BACKGROUND: Local nationals with complex wounds resulting from traumatic combat injuries during Operations Iraqi Freedom and Enduring Freedom usually must undergo reconstructive surgery in the combat zone. While the use of microvascular free-tissue transfer (free flaps) for traumatic reconstruction iswell documented in the literature, various complicating factors existwhen these intricate surgical procedures are performed in a theater of war. METHODS: The microvascular experiences of six military surgeons deployed during a 30-month period between 2006 and 2011 in Iraq and Afghanistan were retrospectively reviewed. RESULTS: Twenty-nine patients presentedwith complex traumaticwounds. Thirty-one freeflapswere performed for the 29 patients. Location of tissue defects included the lower extremity (15), face/neck (8), upper extremity (6). Limb salvage was successful in all but one patient. Six of eight patients with head and neck wounds were tolerating oral intake at the time of discharge. Therewere three flap losses in 3 patients; two patients who experienced flap loss underwent a successful second free or regional flap. Minor complications occurred in six patients. CONCLUSION: Microvascular free tissue transfer for complex tissue defects in a combat zone is a critically important task and can improve quality of life for host-nation patients. Major US combat hospitals deployed to a war zone should include personnel who are trained and capable of performing these complex reconstructive procedures and who understand the many nuances of optimizing outcomes in this challenging environment.


Descriptors :   *PLASTIC SURGERY , AFGHANISTAN CONFLICT , AMPUTATION , IRAQI WAR , MILITARY MEDICINE , MILITARY SURGEONS , TISSUES(BIOLOGY) , TRAUMA , WOUNDS AND INJURIES


Subject Categories : Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE