Features of the Military Field Surgery

Military DoctorThe military-field surgery – the surgery section of military medicine, the object of study of which are pathologies military injuries, their diagnostics, clinical course and treatment methods, as well as organization of surgical care for the wounded at the stages of medical evacuation in the active army and in the rear of the country.

Military Surgery as opposed to the surgery of peaceful time has a number of features that are formed in different combat conditions. The first of them – the mass character of work. The war, in the words of the great Russian surgeon, founder of the military field surgery N. Pirogov – is the traumatic epidemic, and, like any epidemic, it’s characterized by a significant number of wounded who fill and overflow the field hospitals in a short time, where medical assistance is providing.

The second feature of Military Field Surgery consists in the organization of work, particularly on admission to medical facilities a large number of casualties and wounded. This peculiarity was also noticed by NI Pirogov, who warns that “if the doctor in these cases will not act first of all an administrative, and then the medical, he will quite taken aback, and neither his head nor his hands will not help”.

Another peculiarity Military Field Surgery is constant readiness of field medical establishment for relocation and organization of surgical work in new areas and new conditions, depending on the military and tactical situation. Readiness to the displacement means the ability to organize and to work at any time of year and under any weather in different geographic zones and conditions (in tents, barracks, destroyed houses and mud huts).

The distinguishing feature of Military Field Surgery is also dependence of surgical interventions on the military and tactical medical situation. It means that in many cases is necessary to limit the provision of surgical care to wounded and affected the most minimal amount, although it could be provided exhaustively. Such conditions may be when the hospitals are overloaded (when the number of incoming wounded is much higher than the operational capacity) and in case of urgent need to move the troops. In such situations surgeons must limit the provision of surgical help only to those of needy which cannot be evacuated because of the risk of further death. This peculiarity of Military Field Surgery requires the introduction to a surgical work entirely not typical element of peacetime surgery, which is called “sorting of wounded”.

Another feature of Military Field Surgery is the necessity of a unified leadership of all surgical work in accordance with developed and approved guidelines (“Guidelines for the Military Surgery”). It is caused by the fact that the treatment of wounded man during the war carried out in different health care facilities (stages of evacuation). The success of treatment largely determined by the provision of continuity. And if at the next stage of medical evacuation the treatment will be implemented without considering the previous one, it will have a very negative effect on its results and the timing.

Therefore, the task of Military Surgery is the development of mandatory for all Military Field Surgical Doctrine, that regulates the treatment methods of combat injuries, which determines the most effective methods of treatment and forbidding inefficient and time consuming ones, though very resultative in peacetime. In addition, the acceptable only those methods that correspond to the organizational structure and equipment of the field military health facilities.