"Ruck-Truck-House-Plane" Plan Application for the Management of Combat-Related Wound Infections and Prevention of Multidrug-Resistant Organism Spread in Prolonged Field Care Scenarios

J Spec Oper Med. 2025 Dec 1;25(4):53-55. doi: 10.55460/8OQN-UU7U.

Abstract

Wound infections represent an increasing risk in combat trauma, especially in prolonged casualty care conditions char-acterized by evacuation delays and resource scarcity. This risk is compounded by multidrug-resistant organisms, which are difficult to detect and treat in austere settings. This article introduces a "Ruck-Truck-House-Plane" model for infection control and wound management in prolonged casualty care (Role 1) and prolonged care (beyond Role 1) environments. This original approach includes practical procedures and de-cision-making from point of injury to tertiary care transfer. It emphasizes early decontamination, phased surgical care, re-mote microbial diagnostics, and antimicrobial stewardship to reduce morbidity and mortality in modern warfare.

Keywords: combat-related wound infection; military trauma; multidrug-resistant organisms; prolonged care; prolonged casualty care.

Publication types

  • Practice Guideline

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antimicrobial Stewardship
  • Decontamination
  • Drug Resistance, Multiple, Bacterial*
  • Humans
  • Infection Control* / methods
  • Military Medicine*
  • Military Personnel
  • War-Related Injuries* / therapy
  • Wound Infection* / diagnosis
  • Wound Infection* / drug therapy
  • Wound Infection* / microbiology
  • Wound Infection* / prevention & control
  • Wound Infection* / therapy

Substances

  • Anti-Bacterial Agents