{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T09:59:38Z","timestamp":1781258378770,"version":"3.54.1"},"reference-count":3,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The widespread deployment of tactical drones in modern warfare has fundamentally altered battlefield conditions and medical evacuation protocols. This study examines the impact of drone warfare on tourniquet application and care of personnel with extremity hemorrhages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective comparative analysis of patients treated with hemostatic tourniquets at Forward Surgical Teams (FST) during 2 defensive operations: January-April 2025 (drone warfare era) versus 2016 (pre-drone era). Primary outcomes included evacuation times, tourniquet effectiveness, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>80 patients with extremity tourniquets were treated in 2025 versus 69 in 2016. Over 60% of patients in 2025 arrived beyond the safe tourniquet timeframe (&amp;gt;3 hours) compared to 15% in 2016. Drone-related injuries accounted for 65% of cases in 2025. Ineffective tourniquet application increased from 17.4% (2016) to 37.5% (2025). Medical evacuation stages were forced to relocate 10-15 km further from the contact lines because of drone threats.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tactical drone warfare significantly impairs medical evacuation efficiency and increases complications from prolonged tourniquet application. These findings highlight the urgent need for alternative hemorrhage control methods and adapted evacuation protocols for modern combat environments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag263","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:46:13Z","timestamp":1779363973000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of Tactical Drone Warfare on Tourniquet Application and Medical Evacuation: A Comparative Analysis of Combat Operations"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6320-5108","authenticated-orcid":false,"given":"Vladyslav","family":"Yatsun","sequence":"first","affiliation":[{"name":"National Military Medical Clinical Center \u201cMain Military Clinical Hospital\u201d of the Ministry of Defense of Ukraine , Kyiv 02138,","place":["Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6797-8669","authenticated-orcid":false,"given":"Julian","family":"Ungar-Sargon","sequence":"additional","affiliation":[{"name":"U.S. Department of Homeland Security United States Coast Guard Auxiliary AX-5008007 Flotilla 1-7"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8892-4061","authenticated-orcid":false,"given":"Kostiantyn","family":"Gumeniuk","sequence":"additional","affiliation":[{"name":"Armed Forces of Ukraine , Kyiv 03069,","place":["Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9527-6613","authenticated-orcid":false,"given":"Rostyslav","family":"Gybalo","sequence":"additional","affiliation":[{"name":"National Military Medical Clinical Center \u201cMain Military Clinical Hospital\u201d\u2014Leading Surgeon , Kyiv 04050,","place":["Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1036-0355","authenticated-orcid":false,"given":"Serhii","family":"Korol","sequence":"additional","affiliation":[{"name":"Department of Military Surgery, Ukrainian Military Medical Academy , Kyiv 01015,","place":["Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4462-9922","authenticated-orcid":false,"given":"Roman","family":"Kuziv","sequence":"additional","affiliation":[{"name":"Zaporizhzhia Military Hospital , Zaporizhzhia 69000,","place":["Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0305-1570","authenticated-orcid":false,"given":"Iurii","family":"Mikheiev","sequence":"additional","affiliation":[{"name":"Zaporizhzhia Military Hospital , Zaporizhzhia 69000,","place":["Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"2026061205172592000_usag263-B1","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1093\/milmed\/usac208","article-title":"Application of hemostatic tourniquet on wounded extremities in modern \"trench\" warfare: the view of a vascular surgeon","volume":"189","author":"Yatsun","year":"2024","journal-title":"Mil Med"},{"key":"2026061205172592000_usag263-B2","doi-asserted-by":"publisher","first-page":"e54","DOI":"10.1097\/TA.0000000000004134","article-title":"Rethinking limb tourniquet conversion in the prehospital environment","volume":"95","author":"Holcomb","year":"2023","journal-title":"J Trauma Acute Care Surg"},{"key":"2026061205172592000_usag263-B3","doi-asserted-by":"publisher","first-page":"2079","DOI":"10.3390\/biomedicines12092079","article-title":"Comparison of different animal models in hindlimb functional recovery after acute limb ischemia-reperfusion injury","volume":"12","author":"Zheleznova","year":"2024","journal-title":"Biomedicines"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag263\/68515752\/usag263.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag263\/68515752\/usag263.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T09:17:36Z","timestamp":1781255856000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article\/doi\/10.1093\/milmed\/usag263\/8706693"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,12]]},"references-count":3,"URL":"https:\/\/doi.org\/10.1093\/milmed\/usag263","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,12]]},"article-number":"usag263"}}