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In-the-Field Facial Surgery Helps Injured Troops in Iraq
Date:11/20/2007

ernal fixation of a facial fracture.

"We were able to treat them acutely, so bacteria were not at the level where they overcome the patient," Lopez said. He wrote the paper with Dr. Jonathan L. Arnholt, another plastic surgeon at the 322nd, who, like Lopez, is now at the Wilford Hall Medical Center in San Antonio. Lopez is chief of facial plastic surgery at Wilford Hall.

Lopez said he had not been keeping records of on-the-spot facial surgery in Iraq since he left the area. "But we're trying to work on it," he said. "We keep asking people there for numbers. Anecdotally, I can tell you that those people are following the criteria."

Troops who suffer facial wounds often require extensive long-term care, said Dr. Catherine Wilson, who was chief of facial and plastic reconstructive surgery at Walter Reed Army Medical Center in Washington for four years. She now is in private practice in Carmel, Ind., and is a clinical professor of otolaryngology at Indiana University.

"Even in my practice now, I am seeing a lot of long-term issues with aggressive scarring," Wilson said. "Five years out from the injury, you need top-notch surgery to maintain the outcomes."

Extensive scarring can be a continual problem for some patients, Wilson said. "I have several of them in my practice now, and some troops need multiple procedures," she said.

Getting troops to surgery faster after a face wound can reduce the need for such drastic longer-term care, Lopez said.

"One thing the military has definitely done right in this war is patient care and movement," he said.

More information

Learn more about military medicine from the Uniformed Services University.



SOURCES: Manuel L. Lopez, M.D., chief, facial plastic surgery, Wilford Hall Medical Center, San Antonia; Catherine Wilson, M.D., plastic surgeon, Carmel,
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