Operation Iraqi freedom: Surgical experience of the 212th mobile army surgical hospital

Seven hundred one patients were treated at and 394 were admitted to the 212th Mobile Army Surgical Hospital in Central Iraq during the combat phase of Operation Iraqi Freedom. Ninety of those patients underwent 100 operations, with 187 procedures in 19 days. At the peak of hostilities, 48 patients were admitted, 15 operations were performed, and 56 patients were medically evacuated during different 24-hour periods. Thirty-three patients required the surgical expertise of a general or thoracic surgeon. Although 82% of injuries and 70% of the procedures were orthopedic in nature, orthopedic operating room utilization was only 60% of total operating room time (156 hours). The general and thoracic injuries were labor-intensive, frequently requiring two surgeons. Although orthopedic injury remains the predominant reason for surgical intervention on the battlefield, there remains a need to forward-deploy general and thoracic surgeons, because of the presence and complexity of nonorthopedic trauma.