Surgical Services and Transformation of Civil Hospital During “August War 2008” in Georgia

Abstract

Structural transformation of a civil hospital into a military one during "August War 2008" (August 8-12) in Georgia is presented. Damage-control principles, such as hemorrhage control, liver-packing and abdominal tamponade, gastrointestinal tract resection without formation of anastomoses, and other temporary interventions were prioritized. This provided a chance to empty the hospital in a short period to provide the admission of an increased number of combat casualties. There were soldiers from Georgian troops, civilians, and captives of war. The number of total admitted patients was 739. Fifty-two patients were operated on in the surgery department. The following operations were carried out: removal of foreign bodies from the neck region, 6 cases; isolated thoracotomy, pulmorrhaphy, and drainage, 2 cases; laparotomy, hepatorrhaphy, gastrorrhaphy, splenectomy, resection of small intestine, and colostomy, 18 cases; combined operations (thoracotomy plus laparotomy), 9 cases; extended debridement and dressing of wounds, 11 cases; angiosurgical operations, 4 cases; and coloplasty, 2 cases. There were 2 cases of mortality, 1 case of rethoracotomy, and 3 cases of relaparotomy: 2 because of intracavital bleeding and 1 because of sanation.

Surgical outcomes of a civil war in a neighbouring country

“…To reduce the transfer time in a war occurring in a nearby country, the civilian hospitals that are closer to the border should be transformed to military ones. During ‘August War 2008’ in Georgia, a civil hospital was transformed to a military one and provided surgery according to damage control principles 24. Transformation of a civilian hospital to a military one near to the border provides decreased transport time from battlefield to medical centre, correct triage for effective surgical treatment and initial intervention, if possible, in the golden hour.…”