Combat Trauma

Acute post-amputation pain remains a significant clinical challenge in patients with combat-related lower limb injuries and may negatively affect early rehabilitation, mobility, and opioid consumption. Various regional analgesia techniques and cryoanalgesia have been proposed to improve pain control; however, evidence regarding their feasibility and clinical utility in military trauma populations remains limited. The aim of this pilot study is to assess the feasibility of conducting a future randomized controlled trial evaluating different approaches to acute post-amputation pain management in patients with combat-related lower limb injuries. This prospective non-randomized pilot study will enroll 36 adult patients undergoing lower limb amputation or reamputation following combat-related trauma. Participants will be allocated to one of three groups according to clinical indications and multidisciplinary team decision: continuous peripheral nerve blocks, preoperative cryoablation, or standard multimodal analgesia. The primary outcomes will assess study feasibility, including recruitment rate, study completion rate, protocol adherence, and completeness of data collection. Secondary outcomes will include pain intensity assessed using the Numeric Rating Scale (NRS), opioid consumption expressed as Morphine Milligram Equivalents (MME), early mobility assessed using the Basic Amputee Mobility Score (BAMS), time to first standing and ambulation, and treatment-related complications. Participants will be followed for 7 days after surgery, with an additional assessment at 1 month.

Drone-related combat injuries have become one of the most devastating mechanisms of injury in modern warfare. These injuries often cause extensive tissue devitalization, contamination, open fractures, vascular injuries, and complex soft tissue damage, which may substantially increase the risk of severe wound infection, multidrug-resistant bacterial infection, repeated surgical procedures, limb loss, and sepsis. However, the relationship between the extent of tissue devitalization and the development of severe infection has not been systematically investigated. The DRONE-WOUND Study is a prospective observational cohort study designed to evaluate the association between tissue devitalization and severe wound infection in patients with drone-related combat trauma. The study will collect detailed clinical, surgical, microbiological, and radiological data from injured patients treated at participating trauma centers. Measures of tissue injury, contamination, surgical management, microbiological findings, and infection outcomes will be analyzed to identify factors associated with severe infection and poor clinical outcomes. The findings of this study are expected to improve understanding of the mechanisms leading to infection after drone-related injuries, support early identification of high-risk patients, and inform future strategies for surgical management, antimicrobial therapy, and infection prevention in combat trauma. Ultimately, the study aims to improve limb salvage, reduce infectious complications, and enhance outcomes for patients with severe drone-related injuries.

This study aims to evaluate the relationship between evacuation time, tourniquet use, and the development of post-traumatic stress disorder (PTSD) in patients with combat-related amputations. In the context of modern warfare, prolonged evacuation times and extended tourniquet application may contribute not only to physical injury but also to psychological trauma. The study will prospectively follow patients over 18 months to identify key predictors of PTSD and to assess their interaction.