The United States Army 102nd Forward Surgical Team (FST) was deployed to Kandahar
Airfield, Afghanistan, from August 2002 to March 2003, in support of Operation Enduring
Freedom. The unit's primary mission was to provide trauma surgical support to units
of the 101st and 82nd Airborne Divisions, to coalition special operations units, and
to allied Afghan militia forces. The FST's mission was expanded to include humanitarian
The mission was accomplished in the austere environment of Kandahar Airfield, Afghanistan.
The FST was set up in a corner of the abandoned Kandahar International Airport terminal.
The team's supporting facility was a 44-bed combat support hospital at Bagram Airbase
near Kabul. Patients arrived by ground ambulance, local transportation, and MediVac
helicopter. Evacuation of casualties, when necessary, was by fixed-wing aircraft.
Patient data were retrospectively reviewed.
The team performed 112 surgeries on 90 patients during the course of 7 months. Three
patients were female (all children). Twenty patients were <19 years old. Trauma accounted
for 78% of cases; the remainders were nontrauma or elective cases. Sixty-seven percent
of these surgeries were performed on Afghan militia and civilians, 30% on United States
soldiers, and 3% on other coalition forces. Mechanism of injury included gunshot wounds
(34%), blasts (18%), motor vehicle crashes (14%), stab wounds (5%), and other trauma
(7%). By physiological system, the trauma cases were broken down into extremity (44%),
head and neck (17%), multisystem (13%), trunk (8%), and vascular (3%).
“Damage control” operations necessitating multiple trips to the operating room were
the norm. Hypothermia from blood loss was often exacerbated by exposure before evacuation
and prolonged transport in helicopters. This was aggressively treated with passive,
conductive, and active rewarming techniques. Stabilization and evacuation to higher
echelons of care was common.