title: Role 2 military hospitals: results of a new trauma care concept on 170 casualties.
abstract: BACKGROUND
  In recent military conflicts, military surgeons encounter more high-energy injuries associated with explosives. Advances in the field care and shorter evacuation time increased survival. However, casualties still incur severe injuries especially to the extremities. We present wound patterns, anatomical distribution and severity of injuries in a Role 2 hospital.
  
  
  METHODS
  Two years data have been retrospectively reviewed. Only explosives and firearms injuries were included in the study. Patient profile, admission details, mechanism of injury, AIS anatomical locations, ISS, surgical and medical treatments have been analyzed.
  
  
  RESULTS
  Data revealed 170 male casualties. IEDs and GSW accounted for 133 (78%) and 37 (22%) casualties, respectively. An average of 1.8 IED and 1.2 GSW anatomical locations were exposed to injuries. Regardless of the mechanism, injuries were most commonly located in the extremities. IEDs caused significantly higher soft tissue injuries.
  
  
  CONCLUSIONS
  Explosives do not necessarily cause more severe injuries than firearms. However, fragments create multiple, complicated soft tissue injuries which constitute more than half of the injuries. Timely wound debridement and excision of contaminated tissue are crucial to manage extremity soft tissue injuries.
  
  
  CONCLUSIONS
  Casualty care should be assessed within the context of the capabilities present at a hospital and the cause, type and severity of the wounds. The NATO description of Role 2 care only requires an integrated surgical team for damage control surgery with limited diagnostic and infrastructural capabilities.
authors.affiliation: Department of General Surgery, GATA Military Medical Academy, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Ünlü
authors.forename: R A
authors.initials: RA
authors.lastname: Cetinkaya
authors.forename: T
authors.initials: T
authors.lastname: Ege
authors.forename: P
authors.initials: P
authors.lastname: Ozmen
authors.forename: V
authors.initials: V
authors.lastname: Hurmeric
authors.forename: M T
authors.initials: MT
authors.lastname: Ozer
authors.forename: P
authors.initials: P
authors.lastname: Petrone
mesh_terms: D000293:Adolescent; D000328:Adult; D001753:Blast Injuries / Q000401:mortality / Q000628:therapy*; D003422:Critical Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D006295:Health Resources; D006772:Hospitals, Military / Q000706:statistics & numerical data*; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D008887:Military Medicine / Q000458:organization & administration*; D008889:Military Personnel / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000401:mortality / Q000628:therapy*; D015599:Trauma Severity Indices; D014421:Turkey / Q000453:epidemiology; D000067398:War-Related Injuries / Q000401:mortality / Q000628:therapy*; D014950:Wounds, Penetrating / Q000401:mortality / Q000628:therapy*