• Laura Ikni, Laura Valbousquet, Frederique Dufour-Gaume, and Julien Potet.
• Percy Teaching Hospital, Clamart 92140, France.
• Mil Med. 2024 Oct 10.

IntroductionHigh-intensity conflicts are on Europe's doorstep. The French expertise in the medical management of frontline casualties in overseas operations is well established. However, in the management of severe trauma, we lack data on the injuries identified by body scanners in the field. Understanding the associations between injury mechanisms and radiological lesions would enable us to anticipate medical and surgical management. To study this possible link, we collected and interpreted scanogaphic data and analyzed them according to lesion mechanisms, following the algorithm MARCH used to implement the concept of Damage Control Resuscitation, which includes life-saving measures to ensure that the wounded reach medical-surgical facilities alive.Materials And MethodsThis retrospective monocentric study collected data from body scanners performed in overseas operations between June 2011 and September 2023. Inclusion criteria were to be French military personnel and to have undergone a whole-body scanner in a theater of overseas operations. Exclusion criteria were to have died before the scan, to be foreign, non-military and a minor. Of 164 available files, 96 were eligible, 1 patient declared aged 70 years was excluded, and 95 files were retained.ResultsIn our population, 18% of injured patients had a spinal fracture. Compared with road traffic accident casualties, improvised explosive device casualties were the most severely injured patients arriving alive at computed tomography, with a relative risk of Injury Severity Score > 8 of 2.29 [1.09-4.80] (P = .019). Improvised explosive device casualties had a relative risk of airway injuries of 2.57 [1.03-6.39] (P = .030), injuries leading to functional impairment of 3.21 [1.17-8.82] (P =.013), injuries leading to infection of 2.14 [1.21-3.76] (P = .0045), and injuries leading to shock of 3.21 [0.96-10.70] (P = .039). Deep metal splinters were only found in the improvised explosive device group.ConclusionPreparing the medical corps to deal with war casualties is fundamental. Our study shows that it is essential to consider the mechanism of injury to understand the casualty better and predict potential injuries. In addition, the study of postmortem scans could greatly help analyze potentially avoidable deaths.© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.

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