Plastic surgeons on front lines in Iraq

USA Today (Society for the Advancement of Education), Oct, 2005

When most people think of plastic surgeons, they imagine facelifts, liposuction, and tummy tucks--but ask a soldier injured in Iraq and he or she will tell a different story, relates the American Society of Plastic Surgeons, Arlington Heights, Ill.

"As plastic surgeons, we use our general surgery training to help treat initial trauma in the field to save the patient's life or limb. From there, they are transferred to Germany to help them stabilize, clear the infection, and allow the wound to [start to] heal," says ASPS member surgeon Lieut. Col. Andrew Friedman, who has commanded a forward deployed surgical team while serving in Iraq and Afghanistan. "Back in the United States, however, we are using our plastic surgery training to reconstruct soldiers' injuries, close the wounds, and help them feel whole again."

Plastic surgeons work alongside other surgeons and physicians in combat support hospitals to address the immediate needs of the injured. Because of the severity of many war wounds, plastic surgery is not performed in the field. Instead, they treat the wound first to ensure it is free from infection and then fly the soldier home to receive additional medical and reconstructive measures.

Homemade roadside bombs and high-velocity guns pose the biggest threats to soldiers in Iraq, notes Friedman. The most common injuries are wounds in the lower and upper extremities as well as the face. Although soldiers wear body armor with built-in plates, the arms, face, and legs remain exposed. Helmets protect the head but leave the face susceptible to injury.

"Convoys are the scariest and most high-risk activity a soldier can participate in," relates Friedman. "You never know when there is going to be a bomb alongside you or even under your vehicle. Also, the guns used in combat in Iraq don't create the kind of wounds a street gun might in America. These guns fire at a much higher velocity, creating a lot more damage."