Microvascular reconstructive surgery in Operations Iraqi and Enduring Freedom: The US military experience performing free flaps in a combat zone Article

Full Text via DOI: 10.1097/TA.0b013e318299da23 PMID: 23883913 Web of Science: 000330461100024

Cited authors

  • Klem, Christopher; Sniezek, Joseph C.; Moore, Brian; Davis, Michael R.; Coppit, George; Schmalbach, Cecelia


  • 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 is well documented in the literature, various complicating factors exist when 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 presented with complex traumatic wounds. Thirty-one free flaps were 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. There were 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. Copyright (C) 2013 by Lippincott Williams & Wilkins

Publication date

  • 2013

International Standard Serial Number (ISSN)

  • 2163-0755

Start page

  • S228

End page

  • S232


  • 75