Wartime injuries can be some of the most devastating injuries that a Plastic Surgeon encounters in his or her career. Despite the significant trauma that improvised explosive devices and large caliber weapons can cause, improved front-line medicine means that a significant number of soldiers survive their immediate injuries. Thus, more and more soldiers require treatment of devastating injuries that were previously not survivable.

In the May issue of PRS Global Open, Sliesarenko et al. describes using this technique to treat extensive soft tissue battlefield injuries in Ukraine. They report a series of 25 patients aged 22 to 52, all male, who suffered extensive gunshot and mine blast injuries ranging from small (2.5 x 7.5 cm) to very large (12 x 22 cm). Using Keystone Perforator Flaps, they were able to treat these patients and provide them with the tissue needed to cover their wounds. This was done with relatively minor complications and an average surgery time of 68 minutes.