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Original article
The 7th French Airborne Forward Surgical Team experience of surgical support to the population of a low-income country: a prospective study on 341 patients with short-term follow-up
  1. Yvain Goudard1,2,
  2. C Butin1,3,
  3. C Carfantan4,
  4. G Pauleau1,2,
  5. E Soucanye de Landevoisin1,5,
  6. G Goin2,6,
  7. D Clement1,7,
  8. J Bordes1,8 and
  9. P Balandraud9
  1. 1 7th Airborne Forward Surgical Team, Marseille, France
  2. 2 Visceral and Digestive Surgery Unit, Laveran Military Hospital, Marseille, France
  3. 3 Orthopedic Surgery Unit, Saint-Anne Military Hospital, Toulon, France
  4. 4 Operational Headquarters, French Military Health Service, Paris, France
  5. 5 Orthopedic Surgery Unit, Laveran Military Hospital, Toulon, France
  6. 6 5th Forward Surgical Team, Marseille, France
  7. 7 Anesthesiology and Intensive Care Unit, Begin Military Hospital, Saint-Mande, France
  8. 8 Anesthesiology and Intensive Care Unit, Saint-Anne Military Hospital, Toulon, France
  9. 9 Visceral and Digestive Surgery, Saint-Anne Military Hospital, Toulon, France
  1. Correspondence to Dr Yvain Goudard, general surgery, Laveran military hospital, Marseille 13013, France; yvaingoudard{at}yahoo.fr

Abstract

Background The 7th Airborne Forward Surgical Team (FST) has deployed to Chad in 2015 and 2016, in support of French military forces. Humanitarian surgical care is known to represent a significant part of the surgical activity in such missions, but to date limited data have been published on the subject.

Methods All surgical patients from a civilian host population treated by the FST during these missions have been prospectively included. Indications, operative outcomes and postoperative outcomes were evaluated.

Results During this period, the FST operated on 358 patients. Humanitarian surgical care represented 95% of the activity. Most patients (92.7%) were operated for elective surgery. Emergencies and infectious diseases represented, respectively, 7.3% and 9.1% of cases. The mean length of stay (LOS) was three days (2–4), and the median follow-up was 30 days (22–34). Mortality rate was 0.6% and morbidity was 5.6%. Parietal surgery had no significant complication and had shorter LOS (p<0.001). Emergent surgeries were more complicated (p<0.01) and required more reoperations (p<0.05). Surgical infectious cases had longer LOS (p<0.01).

Conclusions Humanitarian surgical care can be provided without compromising the primary mission of the medical forces. Close surveillance and follow-up allowed favourable outcomes with low morbidity and mortality rates. Humanitarian care is responsible for a considerable portion of the workload in such deployed surgical teams. Accounting for humanitarian care is essential in the planning and training for such future medical operations.

  • humanitarian surgical care
  • medical support to population
  • forward surgical team
  • chad

https://doi.org/10.1136/jramc-2018-000952

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    Footnotes

    • Contributors YG contributed to designing the study, collecting and analysing the data, and writing the final manuscript. CB and CC contributed to collecting and analysing the data, and helped in the manuscript review. GP, ESdL, DC and GG helped in collecting the data. JB contributed to designing the study, analysing the data and did the critical revision. PB did the critical revision.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Permission from the Institutional Review Board (College of French Military Surgeons) was obtained prior to data review and analysis. In accordance with the Geneva Conventions and international humanitarian law, every patient referred to our facility who needed emergency care received treatment regardless of his origin or status.

    • Provenance and peer review Not commissioned; externally peer reviewed.