BATTLEFIELD SURGERY: AN EXPERIENCE FROM FORWARD TREATMENT CENTRE WANA

Battlefield Surgery

Abstract

Objective: To profile the spectrum of injuries and management of casualities treated in forward treatment centre (FTC) Wana over a period of one year by optimizing the available resources of a Field Hospital.
Study Design: Descriptive cross sectional study.
Place and Duration of Study: Forward treatment center Wana South Waziristan Agency, from 21 Jan 2014 to 08 Dec 2014.
Material and Methods: A total of 62 cases brought in FTC were included in the study. Cases were managed according to Advanced Trauma Life Support (ATLS) protocol. A policy of aggressive resuscitation, early primary repair of injuries and evacuation was followed at our setup.
Results: All patients were male with a mean age of 28.1 ± 4.443 yrs. The majority of casualties were military (52 cases, 83.9%) and the major cause of injury was found to be improvised explosive device (33 cases, 53.2%). Extremities were involved in majority of casualties (38 cases, 50.7%). A total number of 91 operations were performed in 62 cases which included 14 laparotomies (15.4%), 21 chest intubations (23%), 9 amputations (9.9%), 19 cases of debridement (20.9%), 10 fasciotomies (11%), 1 tendon repair (1.1%), 10 closed reduction of fractures (11%), 5 closed reduction of dislocations (5.5%) and 2 cases of extremity vascular repair (2.2%).
Conclusion: Optimal utilization of limited resources warrants a responsible approach of surgeons towards injured brought at FTCs. A variety of injuries may be encountered by the forward surgical team who can significantly contribute by providing life and limb saving surgery.