Lessons learned from the experience of visceral military surgeons in the French role 3 Medical Treatment Facility of Kabul (Afghanistan): An extended skill mix required

Acute neurosurgical management of traumatic brain injury and spinal cord injury in French armed forces during deployment

“…Care is pursued to complete stabilization before air medevac. 4 Comprises specialist surgical and medical procedures, reconstruction, rehabilitation, and convalescence. This level of care is usually highly specialized, time-consuming, and normally provided in the country of origin.…”

“…6,9 Neurosurgical damage control guarantees a medevac as safe as can be expected between the conflict zone and a homeland hospital. 4,18 Its objective is to directly control intracranial pressure elevations, particularly when neuromonitoring is lacking due to limited resources. 18 Later, depending on the clinical course, the skull will be reconstructed using 3D prosthetics as soon as possible.…”

“…As a consequence, the basic craniectomy techniques (reverse question-mark temporofrontoparietal incision, performing a bone flap by manual trephine-made burr holes and Gigli saw, opening dura mater, cerebral wound debridement) are taught to all French military surgeons during the advanced deployment surgery course (in French: Cours Avancé de Chirurgie en Missions Extérieures; CACHIRMEX). 4 This 5-module workshop allows orthopedic and general surgeons to learn war surgery basics with all specialties encompassed. Module 3 focuses on head and neck.…”

The 7th French Airborne Forward Surgical Team experience of surgical support to the population of a low-income country: a prospective study on 341 patients with short-term follow-up

“…This adaptation of MSP is well known10 11 and has been previously described 3–5. In Afghanistan, most MSP patients were treated for war-related injuries4 and MSP aimed to respond to health situations related to crisis. In Ivory Coast, patients were essentially operated on for elective surgery3 and MSP aimed to contribute support to host nation.…”

The French Advanced Course for Deployment Surgery (ACDS) calledCours Avancé de Chirurgie en Mission Extérieure (CACHIRMEX): history of its development and future prospects

“…Since the creation of ACDS, its value has been confirmed by experience given the number and severity of injuries sustained by French soldiers and their outcomes. An analysis of the trauma cases operated on by military surgeons (assigned to the Medical Treatment Facility (MTF) (NATO role 3) in Kabul International Airport (KAIA)) who had recently graduated from ACDS showed that this training proved to be appropriate for the management of the sometimes complex wound associations encountered 9 10…”