title: Oral and maxillofacial surgical contribution to 21 months of operating theatre activity in Kandahar Field Hospital: 1 February 2007-31 October 2008.
abstract: Our aim was to assess oral and maxillofacial operating theatre activity at the NATO Multinational Medical Unit at Kandahar Airfield (MMU KAF). We made a retrospective analysis of the theatre logbook of the MMU KAF between 1 February 2007 and 31 October 2008. During that period, 1778 operations were done for 1639 patients. A total of 563 local civilians (34% of all patients) were operated on. Oral and maxillofacial surgeons were involved in 322/1778 (18%), general surgeons in 943/1778 (53%), and orthopaedic surgeons in 716/1778 (40%) of operations. Neurosurgeons were present only between March and October 2008, resulting in them being involved in 73/789 procedures (9%). Debridement and closure of wounds were the most common procedures in all specialties. A total of 247 operations on the face, neck, and scalp made up 16% of the total operations for trauma (n=1556), but most for coalition service personnel (n=69, 24%). Only 28 operations (10%) on coalition service personnel were done on the torso. This could be accounted for by the increased numbers of blast injuries and the effectiveness of modern body armour among coalition forces. Brain injuries were also more common among this group of patients than among the other groups, showing that helmets have only a limited effect in protecting against the effects of blast injury. Of all procedures, 163 operations (9%) were done for children. Training of general surgeons is becoming more specialised, which may result in greater dependence on larger teams of subspecialists (including oral and maxillofacial surgeons) in future conflicts.
authors.affiliation: Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Breeze
authors.forename: A J
authors.initials: AJ
authors.lastname: Gibbons
authors.forename: J G
authors.initials: JG
authors.lastname: Combes
authors.forename: A M
authors.initials: AM
authors.lastname: Monaghan
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D001134:Arm Injuries / Q000601:surgery; D001753:Blast Injuries / Q000601:surgery; D001930:Brain Injuries / Q000601:surgery; D002648:Child; D003646:Debridement / Q000706:statistics & numerical data; D005151:Facial Injuries / Q000601:surgery; D005260:Female; D005592:Fracture Fixation / Q000706:statistics & numerical data; D013502:General Surgery / Q000706:statistics & numerical data; D006260:Head Protective Devices; D006772:Hospitals, Military; D006801:Humans; D007869:Leg Injuries / Q000601:surgery; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data; D019838:Neck Injuries / Q000601:surgery; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D019647:Oral Surgical Procedures / Q000706:statistics & numerical data*; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D011446:Prospective Studies; D011482:Protective Devices; D012189:Retrospective Studies; D012535:Scalp / Q000293:injuries; D013898:Thoracic Injuries / Q000601:surgery; D014947:Wounds and Injuries / Q000601:surgery*