Management of Soft-Tissue and Bone Defects in a Local Population: Plastic and Reconstructive Surgery in a Deployed Military Setting

ABSTRACT Objective: Gunshot injuries, blast injuries, and major contusions can cause extensive extremity defects. In countries with damaged or destroyed infrastructure, local national patients with these injuries pose a challenge. Deployed medical facilities of the German Armed Forces provide medical care to these patients as part of their humanitarian activities. Reconstructive techniques, for example, microvascular free tissue transfer, can be used only to a limited extent in such settings, which require safe and simple (outpatient) procedures. The focus of treatment is not on cosmetic aspects but on rapidly restoring function. Low-resource settings require ethical and medical compromises. It is still a topic of the discussion which reconstructive surgical procedures could be performed in a deployment mission and which should be in the portfolio of the deployed surgeon. Methods: We conducted a retrospective analysis of a sample of 550 patients who received definitive treatment from seven surgeons from a...