Kosovo 1999--a surgical template for modern conflict.

246 surgical operations were performed in a UK Field Hospital over an eight month period during Op AGRICOLA in 1999. Whilst there were many injuries caused by military weaponry, non-conflict related injuries were also common. Sixteen laparotomies were performed, nine for mine and gunshot injuries, seven were for 'peacetime' causes. Four extremity external fixators were applied--three after high energy transfer fragment wounds to bone and one after a road traffic accident. One pelvic external fixator was applied. Six limbs were amputated, three in one child. Eight split-skin grafts and three local flaps were performed. Wound debridements (including delayed primary suture), of which half were due to fragment and bullet wounds to non-vital structures, were the most common operation performed. Of the 246 consecutive operations analysed, 91 were performed solely by the orthopaedic surgeon. There were 29 combined cases where one surgeon actively assisted the other. 146 operations were performed on local civilians. A consultant orthopaedic surgeon and a consultant general surgeon along with experienced anaesthetic and operating theatre staff remains the combination best suited to provide medical support to future military operations of this kind.