Abstract
Forward surgical teams have been employed in many recent conflicts. However, as in the Gulf War, they have not usually been sited further forward than the Field Ambulance level. During recent operations in Northwest Pakistan and Afghanistan, two Special Forces Field Surgical Teams were forward deployed to isolated and remote desert areas to provide a completely independent surgical facility, backed up only by a small guard force.
Advanced resuscitation and damage control surgery including major vessel ligation, wound debridement and skeletal stabilization was undertaken. These operations all took place within a two resuscitation bay, two table surgical complex set up within a C-130 Hercules aircraft. This allowed for an extremely mobile response to any perceived threats approaching the complex. A small laboratory with a ruggedised ‘Thermopol’ blood refrigeration unit was also carried. This allowed for the forward provision of 50 units of mixed blood type. This facility was found to be life saving.
Following surgical stabilization, these patients were then casevaced by a separate pre-positioned, aeromed pre-fitted C-130 aircraft to a Deployed Operating Base Hospital in Oman. Here, further stabilization surgery, skeletal fixation and wound care was carried out. Twenty-four hours later, all casualties were in a teaching hospital in the UK where final definitive surgery took place.
The management and care of these patients at all of the above stages is presented and discussed with some appropriate lessons for future operations
These abstracts were prepared by Squadron Leader G. Pathak FRCS (Trauma & Orth). Correspondence should be addressed to him at Royal Hospital Haslar, Gosport, Hampshire PO12 2AA.
