Need for "conflict version" of primary surgery: war surgery in the era of low-intensity conflicts.
The conventional wars between nations have widely been replaced by low-intensity conflicts within nations today, resulting in different patterns of injuries and practice of surgical care. A blurred front line, protracted durations of violence, indiscriminant fighting, and the emergence of specific surgical problems characterize low-intensity conflicts. In protracted conflicts with limited resources, surgical outcomes depend on many factors other than surgical skills, such as social/cultural values and economical feasibility. This paper examines how the characteristics of current conflicts affect surgical practice and will address key issues to evolve care to adapt to these changes. Key issues are (1) need for comprehensive surgical skills, (2) importance of improving local capacities, (3) long-term impact of trauma, and (4) limited access to information required to improve surgical skills.
Morikawa
Masahiro J
MJ
Office of International Surgery, Department of Family Medicine, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA. mmkobe@hotmail.com
D002960:Civil Disorders; D002983:Clinical Competence; D013502:General Surgery / Q000458:organization & administration / Q000639:trends*; D006301:Health Services Needs and Demand / Q000458:organization & administration / Q000639:trends*; D006801:Humans; D007398:Interpersonal Relations; D008887:Military Medicine; D014857:Warfare; D014947:Wounds and Injuries / Q000209:etiology / Q000601:surgery