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. 2025 Aug 1;99(3S Suppl 1):S99-S105.
doi: 10.1097/TA.0000000000004720. Epub 2025 Jun 30.

Trauma care of Gazan civilians: Key lessons from the French military humanitarian mission

Matthieu Boye  1 , Nicolas Py, Raphaël Paris, Bertrand Prunet, Antoine Sarda, Antoine Lamblin, Paul Chiron, Edouard Martin
Affiliations

Trauma care of Gazan civilians: Key lessons from the French military humanitarian mission

Matthieu Boye et al. J Trauma Acute Care Surg. .

Abstract

Background: Following the attacks on October 7, 2023, Israel launched a high-intensity air and ground offensive in the Gaza Strip. In late November 2023, France led a humanitarian mission by deploying a Mistral-class landing helicopter dock with enhanced medical-surgical capabilities, positioned in Egypt near Rafah. This study aimed to describe the challenges of a humanitarian trauma mission in a modern conflict by analyzing the activity aboard the French landing helicopter dock, named DIXMUDE.

Methods: This retrospective cohort study included all civilian patients admitted to the DIXMUDE for war-related physical trauma.

Results: During the mission, 124 civilian patients were admitted to the DIXMUDE, 94 of whom sustained war-related physical injuries. Pediatric patients (younger than 15 years) represented 42% of the casualties (40 of 94 patients). Explosions were the primary cause of injury (95%). The median Injury Severity Score was 10, with a predominance of severe limb injuries. Nearly 80% of the victims had undergone damage-control surgery in Gaza before admission, and 50% required surgical reassessment on the DIXMUDE. Moreover, 171 war trauma procedures were performed, primarily orthopedic surgeries (54%). General anesthesia was used in the majority of cases (80%), with combined general and regional anesthesia in 19%. Pediatric surgical cases constituted 40%, with 20% of cases involving children younger than 10 years. Key challenges in trauma care included managing severe pain (37 of 94 patients [39%]), wound infections (20 of 94 patients [21%]) often associated with antimicrobial resistance (65%), and blood management requiring transfusions (13 of 94 patients [14%]).

Conclusion: The challenges of humanitarian war trauma missions require up-to-date skills in pediatrics, infectious diseases, and rehabilitation, including acute pain management and blood management.

Level of evidence: Therapeutics/Care Management; Level IV.

Keywords: Gaza's modern war; Humanitarian war trauma care; surgical care assessment; trauma; wound infections.

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References

    1. Stein R, Willis H, Jhaveri I, Miller D, Byrd A, Reneau N. A times investigation tracked Israel's use of one of its Most destructive bombs in South Gaza. The New York Times. December 22, 2023. Available at: https://www.nytimes.com/2023/12/21/world/middleeast/israel-gaza-bomb-inv... . Accessed April 23, 2024.
    1. Qiblawi T; CNN. ‘Not seen since Vietnam’: Israel dropped hundreds of 2,000-pound bombs on Gaza, analysis shows. December 22, 2023. Available at: https://www.cnn.com/gaza-israel-big-bombs/index.html . Accessed April 23, 2024.
    1. World Health Organization-Regional Office for the Eastern Mediterranean. Gaza Hostilities 2023—Emergency Situation Reports—Issue 14. 2023. Available at: https://www.emro.who.int/images/stories/palestine/oPt_Emergency_Situatio... . Accessed April 21, 2024.
    1. Barbier O, Malgras B, Versier G, Pons F, Rigal S, Ollat D. French surgical experience in the role 3 medical treatment facility of KaIA (Kabul International Airport, Afghanistan): the place of the orthopedic surgery. Orthop Traumatol Surg Res . 2014;100:681–685.
    1. Bonnet S, Gonzalez F, Poichotte A, Duverger V, Pons F. Lessons learned from the experience of visceral military surgeons in the French role 3 Medical Treatment Facility of Kabul (Afghanistan): an extended skill mix required. Injury . 2012;43:1301–1306.