[Orthopedic surgery with limited resources after mass disasters and during armed conflicts : First international guidelines for the management of limb injuries and the experience of Doctors Without Borders]

Unfallchirurg. 2017 Oct;120(10):815-822. doi: 10.1007/s00113-017-0399-x.
[Article in German]

Abstract

Disasters and armed conflicts are often the unfortunate basis for aid projects run by Doctors Without Borders/Médecins Sans Frontières (MSF). The nature of war and disasters means that surgery is an integral part of this medical emergency aid. In these situations, resources are usually limited. As a result, surgical work in these contexts differs significantly from the daily routine of a surgeon working in a highly resourced hospital. The principles of surgery do not change but surgeons must adapt their tactical approach to the changed context otherwise there is a high risk of failing to improve the health of patients and potentially jeopardizing their prospects for recovery. Every experienced war surgeon has learned new skills the hard way. The Field Guide to Manage Limb Injury in Disaster and Conflict has been written to help new surgeons who may face the challenges of disaster and war surgery and to avoid unnecessary suffering for patients ( https://icrc.aoeducation.org ). Under the guidance of the International Committee of the Red Cross (ICRC), with participation of the World Health Organization (WHO), financed by the AO Foundation, and featuring the experiences of experts from different organizations (amongst them MSF), the book details techniques and guidelines for surgery in low resource settings. The following article provides a short summary of some of the surgical challenges when working with limited resources and reflects on a few specific recommendations for so-called war surgery.

Keywords: Disasters; Guidelines; Limited resources; Treatment recommendations; War surgery.

Publication types

  • Practice Guideline

MeSH terms

  • Armed Conflicts*
  • Blast Injuries / surgery
  • Developing Countries*
  • Disasters*
  • Extremities / injuries*
  • Extremities / surgery
  • First Aid / methods
  • Fracture Fixation, Internal
  • Fractures, Closed / surgery
  • Fractures, Open / surgery
  • Global Health
  • Health Resources / supply & distribution
  • Humans
  • Mass Casualty Incidents
  • Medical Missions*
  • Orthopedic Procedures / methods*
  • Physician's Role*
  • Wounds and Injuries / surgery
  • Wounds, Gunshot / surgery