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Modern teaching of military surgery: why and how to prepare the orthopaedic surgeons before deployment? The French experience

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Abstract

Purpose

Improved survival of combat casualties in modern conflicts is especially due to early access to damage control resuscitation and surgery in forward surgical facilities. In the French Army, these small mobile units are staffed with one general surgeon and one orthopaedic surgeon who must be able to perform any kind of trauma or non trauma emergency surgery.

Methods

This concept of forward surgery requires a solid foundation in general surgery which is no longer provided by the current surgical programs due to an early specialization of the residents. Obviously a specific training is needed in war trauma due to the special pathology and practice, but also in humanitarian care which is often provided in military field facilities.

Results

To meet that demand the French Military Health Service Academy created an Advanced Course for Deployment Surgery (ACDS), also called CACHIRMEX (Cours Avancé de CHIRurgie en Mission EXtérieure). Since 2007 this course is mandatory for young military surgeons before their first deployment. Orthopaedic trainees are particularly interested in learning war damage control orthopaedic tactics, general surgery life-saving procedures and humanitarian orthopaedic surgery principles in austere environments.

Conclusion

Additional pre-deployment training was recently developed to improve the preparation of mobile surgical teams, as well as a continuing medical education for any active-duty or reserve surgeon to be deployed.

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Acknowledgments

The authors wish to acknowledge Erwan Saint-Macary for his participation to this article.

Conflict of interest

The authors declare that they have no conflict of interest. The opinions or assertions contained herein are solely those of the authors, and do not necessary reflect the official policy or position of the FMHS.

Author information

Authors and Affiliations

  1. Clinic of Traumatology and Orthopaedics, Percy Military Teaching Hospital, Clamart, France

    Laurent Mathieu, Benjamin Joly & Sylvain Rigal

  2. Clinic of Abdominal, Thoracic and Vascular Surgery, Percy Military Teaching Hospital, Clamart, France

    Stéphane Bonnet

  3. Clinic of Traumatology and Orthopaedics, Desgenettes Military Teaching Hospital, Lyon, France

    Antoine Bertani & Frédéric Rongiéras

  4. French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France

    Stéphane Bonnet, Frédéric Rongiéras, François Pons & Sylvain Rigal

  5. Service de Chirurgie Orthopédique, Traumatologie et Chirurgie Réparatrice des Membres, 101 avenue Henri Barbusse, 92140, Clamart, France

    Sylvain Rigal

Authors
  1. Laurent Mathieu
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  2. Benjamin Joly
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  3. Stéphane Bonnet
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  4. Antoine Bertani
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  5. Frédéric Rongiéras
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  6. François Pons
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  7. Sylvain Rigal
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Corresponding author

Correspondence to Sylvain Rigal.

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Mathieu, L., Joly, B., Bonnet, S. et al. Modern teaching of military surgery: why and how to prepare the orthopaedic surgeons before deployment? The French experience. International Orthopaedics (SICOT) 39, 1887–1893 (2015). https://doi.org/10.1007/s00264-015-2741-7

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  • DOI: https://doi.org/10.1007/s00264-015-2741-7

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