title: Dynamic Insights on Surgical Activity in a New Modern Warfare: The French Role 2 in Bangui, Central African Republic.
abstract: In December 2013, France deployed more than 2,000 soldiers in Central African Republic with two main missions, to restore security and to improve the humanitarian situation. The objectives of this article were to analyze the surgical activity of forward surgical teams in Central African Republic over 2 years and to discuss features of training for deployed surgeons.
  
  
  
  From December 5, 2013, to September 30, 2015, we retrospectively reviewed the electronic surgical database. Surgical activity was described as patient status, type of lesion, surgical procedures performed, and anatomic regions involved.
  
  
  
  During this study period, 431 surgical procedures were performed on 401 patients; 66% of the patients were civilians, 26% French soldiers, and 11% foreign soldiers. Surgical procedures were divided into 34% orthopedic activity and 66% general surgery activity. Orthopedic activity was mainly performed during the first months of the operation Sangaris, whereas general surgery occurred after summer 2014 with a return to peacetime.
  
  
  
  Our study demonstrated original and dynamic insights into the nature of surgical activity throughout the operation with mainly orthopedic surgery during the initial deployment for management of combat casualties and general surgery later, dedicated to elective surgery for local citizens. These data should enhance staffing, training, and deployment of future surgical teams in combat settings with continuous training programs to maintain specific competences, especially in cases of low surgical activity, such as virtual learning or e-learning that could be developed in the future.
authors.affiliation: Orthopaedic Department, Begin Military Teaching Hospital, 69 Avenue de Paris, 94160 Saint Mandé, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Barbier
authors.affiliation: Intensive Unit Care, Percy Military Teaching Hospital, 101 Avenue de Henri Barbusse, 92140 Clamart, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Pasquier
authors.affiliation: Military Medical Center of Vincennes, Fort Neuf de Vincennes, Cours de Maréchaux, 75614 Paris Cedex 12, France.
authors.forename: Maelle
authors.initials: M
authors.lastname: Racle
authors.affiliation: Visceral Surgery Department, Percy Military Teaching Hospital, 101 Avenue de Henri Barbusse, 92140 Clamart, France.
authors.forename: Yoann
authors.initials: Y
authors.lastname: Baudoin
authors.affiliation: Visceral Surgery Department, Begin Military Hospital, 69 Avenue de Paris, 94160 Saint-Mandé, France.
authors.forename: Brice
authors.initials: B
authors.lastname: Malgras
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002488:Central African Republic; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000208:ethnology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D014857:Warfare / Q000941:ethics*