Surgical resuscitation for combat casualties:bottlenecks and generation pathways for the Chi-nese Army
Li Yang
Zhang Lianyang
Abstract：Modern warfare,characterized by high-energy weapons,results in complex,multiple combat inju-ries that need rapid surgical resuscitation in austere environments.This review analyzes the critical bottlenecks hin-dering the development of surgical resuscitation capabilities within the Chinese Army and proposes systematic gener-ation pathways to address these challenges.The concept of surgical resuscitation is defined as the integration of dam-age control surgeries and physiological resuscitation.A comprehensive overview of core surgical skills for injuries to the head,chest,abdomen,and extremities is provided.Four primary bottlenecks are identified:(1)the inherent con-flict between the mobility of medical teams and their mission load capacity;(2)the discrepancy between peacetime sub-specialized training and the need for generalist surgeons in combat;(3)the degradation of fundamental surgical skills using basic instruments("cold weapons")due to reliance on energy platforms;and(4)the widespread lack of experience in open-cavity surgeries due to the prevalence of minimally invasive techniques.To overcome these di-lemmas,a two-tiered generation path is proposed.The foundational level involves adopting standardized trauma train-ing(e.g.,ATLS,China Trauma Care Training®)and fostering deep military-civilian integration with regional trau-ma centers.The innovative level focuses on building multi-dimensional,combat-oriented capabilities through manda-tory cross-specialty training,reinforcement of basic surgical techniques,a renewed focus on open surgery proficiency,development of diverse learning platforms,and a shift towards realistic,capability-testing combat drills.This review provides a strategic framework and practical approaches to systematically enhancing the surgical resuscitation capa-bility of the Chinese military surgeons,ensuring readiness for future combat medical support missions.
Keywords：Combat casualtiesSurgical resuscitationDamage control surgeryCapability buildingMili-tary-civilian integration
Publication Date：2025-12-15
Online Publishing Date：2026-01-05(First online date of this platform, not the publication date of the document)
Pages：5( 905-909 )