Surgical support during the terrorist attacks in Paris, 13 November 2015: experience at Begin Military Teaching Hospital.

Background: Recent conflicts have allowed the French Army Health Service to improve management quality for wartime-injured people during military operations. On 13 November 2015, it was in Paris that France was directly attacked and Begin Military Teaching Hospital, like several hospitals in Paris, had to face a large number of gunshot victims. Thanks to our operational experience, injured people hospitalized in military hospitals benefited from a management based on triage and damage control (DC) principles. Methods: Forty-five patients were taken care of in our hospital with an average age of 32. During triage, 8 patients were categorized T1 (with 4 extreme emergencies) and 10 were classified T2 and 27 as T3. Twenty-two patients underwent emergency surgery, 15 for soft tissue lesions of limbs, 8 for ballistic fractures (one of which was a cervical wound), and 5 for abdominal wounds. Two patients classified T1 died early. Results: In total, more than 50 operations were performed including iterative debridements, bone fixation, three amputations, and two flaps. After 9 months, all of the patients had healed. One woman with limb stiffness required an arthrolysis. Conclusion: This event showed that terrorist attacks and mass casualties with war wounds can occur in France. Acquired experience regarding war wounds by the French Army Health Service is precious. Everyone must understand the importance of triage and the principles of Damage Control. Every hospital must be ready to face this type of massive influx of injured people (white plan). Level of Evidence: Level IV (therapeutic study/care management) (C) 2017 Lippincott Williams & Wilkins, Inc.

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