Surgery in Armed Conflicts: Predicting Surgical Treatment Needs and Improving Resource Use in ResourceConstrained Settings

Sammanfattning

In armed conflicts, civilian healthcare struggles to cope with limited or no
surgical resources. Understanding the relationship between demographics,
injury mechanism, and injury patterns to predict what resources are needed is
therefore vital. To explore this, medical records were obtained from patients
with weapon-related wounds, treated at three International Committee of the
Red Cross (ICRC) hospitals. Differences in injury mechanisms, injury patterns,
and treatments between the sexes and over time were analysed, as well as the
possibility of predicting surgical resource consumption. At these hospitals,
most patients were men in their twenties with injuries to their arms or legs.
Treatment of soft tissue injuries was the most common surgery type. Less than
20% of patients underwent major surgery and mortality during hospital stay
was less than 5%. The use of fracture stabilization measures and skin grafts has
decreased in recent decades, while the risk of amputation has remained
unchanged. Women were injured to a greater extent by indiscriminate weapons,
had more serious injuries, received blood transfusions more often, and were
treated with more extensive surgery than men. The descriptive Red Cross
Wound Score (RCWS) was better at predicting surgical resource consumption
than scoring systems used in civilian trauma care.