title: Shaping the military wound: issues surrounding the reconstruction of injured servicemen at the Royal Centre for Defence Medicine.
abstract: The conflict in Afghanistan has produced injuries similar to those produced from military conflicts for generations. What distinguishes the modern casualty of the conflict in Afghanistan from those of other conflicts is the effectiveness of modern field medical care that has led to individuals surviving with injuries, which would have been immediately fatal even a few years ago. These patients present several challenges to the reconstructive surgeon. These injured individuals present early challenges of massive soft-tissue trauma, unstable physiology, complex bony and soft-tissue defects, unusual infections, limited reconstructive donor sites, peripheral nerve injuries and traumatic amputations. Late challenges to rehabilitation include the development of heterotopic ossification in amputation stumps. This paper outlines the approach taken by the reconstructive team at the Royal Centre for Defence Medicine in managing these most difficult of reconstructive challenges.
authors.affiliation: Plastic and Reconstructive Surgery, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: Demetrius
authors.initials: D
authors.lastname: Evriviades
authors.forename: Steven
authors.initials: S
authors.lastname: Jeffery
authors.forename: Tania
authors.initials: T
authors.lastname: Cubison
authors.forename: Graham
authors.initials: G
authors.lastname: Lawton
authors.forename: Martin
authors.initials: M
authors.lastname: Gill
authors.forename: Deborah
authors.initials: D
authors.lastname: Mortiboy
mesh_terms: D005121:Extremities / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008887:Military Medicine / Q000379:methods* / Q000639:trends; D008889:Military Personnel; D009999:Ossification, Heterotopic / Q000473:pathology / Q000517:prevention & control; D059348:Peripheral Nerve Injuries; D019651:Plastic Surgery Procedures / Q000379:methods*; D006113:United Kingdom; D014857:Warfare; D014946:Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D014947:Wounds and Injuries / Q000601:surgery* / Q000628:therapy*