{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:28:30Z","timestamp":1790256510540,"version":"4.1.0"},"reference-count":10,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T00:00:00Z","timestamp":1603497600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T00:00:00Z","timestamp":1603497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Military Med Res"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Soft tissue reconstruction is typically conducted after evacuation from theater of operations. If circumstances do not allow timely evacuation, however, defect site may need to be reconstructed in the combat zone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A total of 41 patients with extremity soft tissue defect were treated using pedicled flaps by a single orthopedic surgeon during four deployments in Chad, Afghanistan and Mali between 2010 and 2017. The mean age was 25.6\u2009years. A total of 46 injury sites in extremities required flap coverage: 19 combat-related injuries (CRIs) and 27 non-combat related injuries (NCRIs). Twenty of the injury sites were infected. Overall, 63 pedicled flap transfers were carried out: 15 muscle flaps, 35 local fasciocutaneous flaps and 13 distant fasciocutaneous flaps. The flap types used did not differ for CRIs or NCRIs. Mean follow-up was 71\u2009days. Complications included deep infection (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), flap failure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091) and partial flap necrosis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091). Limb salvage rate was 92.7% (38\/41).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Soft tissue defect can be managed with simple pedicled flaps in theatre of operations if needed. Basic reconstructive procedures should be part of the training for military orthopedic surgeons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Retrospectively registered in January 2019 (2019-0901-001).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40779-020-00281-5","type":"journal-article","created":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T03:02:28Z","timestamp":1603508548000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Soft tissue coverage using pedicled flap in combat zone: a case series"],"prefix":"10.1016","volume":"7","author":[{"given":"Laurent","family":"Mathieu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soryapong","family":"Plang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"de l\u2019Escalopier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Charles","family":"Murison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Gaillard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Bertani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Rongieras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","published-online":{"date-parts":[[2020,10,24]]},"reference":[{"issue":"3","key":"281_CR1","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1097\/PRS.0000000000001025","volume":"135","author":"J Sabino","year":"2015","unstructured":"Sabino J, Polfer E, Tintle S, Jessie E, Fleming M, Martin B, et al. A decade of conflict: flap coverage options in traumatic war-related extremity reconstruction. Plast Reconstr Surg. 2015;135(3):895\u2013902.","journal-title":"Plast Reconstr Surg"},{"key":"281_CR2","volume":"3","author":"M Connolly","year":"2016","unstructured":"Connolly M, Ibrahim ZR, Johnson ON. Changing paradigms in lower extremity reconstruction in war-related injuries. Mil Med Res. 2016;3:9.","journal-title":"Mil Med Res"},{"issue":"2 Suppl 2","key":"281_CR3","doi-asserted-by":"publisher","first-page":"S228","DOI":"10.1097\/TA.0b013e318299da23","volume":"75","author":"C Klem","year":"2013","unstructured":"Klem C, Sniezek JC, Moore B, Davis MR, Coppit G, Schmalbach C. Microvascular reconstructive surgery in operations Iraqi and enduring freedom: the US military experience performing free flaps in a combat zone. J Trauma Acute Care Surg. 2013;75(2 Suppl 2):S228\u201332.","journal-title":"J Trauma Acute Care Surg"},{"issue":"10","key":"281_CR4","doi-asserted-by":"publisher","first-page":"2175","DOI":"10.1007\/s00264-014-2398-7","volume":"38","author":"L Mathieu","year":"2014","unstructured":"Mathieu L, Gaillard C, Pellet N, Bertani A, Rigal S, Rongi\u00e9ras F. Soft-tissue coverage of war extremity injuries: the use of pedicle flap transfers in a combat support hospital. Int Orthop. 2014;38(10):2175\u201381.","journal-title":"Int Orthop"},{"issue":"1","key":"281_CR5","first-page":"35","volume":"83","author":"O Barbier","year":"2017","unstructured":"Barbier O, Ollat D, Pasquier P, Rigal S, Versier G. Could the orthopaedic surgeon deployed in auster setting perform flaps on the leg? 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J R Army Med Corps. 2016;162(5):343\u20137.","journal-title":"J R Army Med Corps"}],"updated-by":[{"DOI":"10.1186\/s40779-020-00290-4","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000}}],"container-title":["Military Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40779-020-00281-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40779-020-00281-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40779-020-00281-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:52:20Z","timestamp":1772830340000},"score":1,"resource":{"primary":{"URL":"https:\/\/mmrjournal.biomedcentral.com\/articles\/10.1186\/s40779-020-00281-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,24]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["281"],"URL":"https:\/\/doi.org\/10.1186\/s40779-020-00281-5","relation":{},"ISSN":["2054-9369"],"issn-type":[{"value":"2054-9369","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,24]]},"assertion":[{"value":"2 March 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 October 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2021","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"An amendment to this paper has been published and can be accessed via the original article.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All patients gave oral consent to participate in this case study. This study was approved by the Department of Surgery of the French Military Health Service Academy (2019-0901-001).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"51"}}