This article is taken from the monthly Sciences et Avenir – La Recherche n°912, dated February 2023.
Doctor François Pons is a professor of surgery and former director of the Val-de-Grâce School of Medicine in Paris.
Science and Future: What is golden hour, the current standard in war medicine?
Francois Pons: The golden hour, the first hour during which a casualty must be treated before being evacuated has long been in force. But in a high-intensity conflict, when you no longer have control of the airways and the land routes become too dangerous due to drones and bombardments making evacuations impossible, the question arises of moving to golden day. In other words, the injured person must be stabilized for 24 hours before he has access to the surgery he needs.
What conflicts lead us to think that we will have to adapt to new strategies?
The war in Armenia is causing many deaths. The wounded are not far from hospitals because the conflict is on their territory, but it is very difficult to manage to move them to referral hospitals. They are polywounded, people who have been blown up and riddled with wounds in a high-intensity conflict. The war in Ukraine seems to raise similar issues, even if it will be necessary to analyze the situation in the followingmathwhen we have all the elements.
Will the training of caregivers adapt to these new ways of waging war?
Despite training in surgery, it is not easy to respond to these new aspects of war. The crux of the problem is to manage to control a hemorrhage over such a period of time. Some avenues launched in terms of robotics remain in the state of research. Intra-aortic balloons make it possible to stop some bleeding without operating, but unfortunately not all. Some foams that are injected into the abdomen end up sticking to the tissues. The challenge will above all be to admit the number of deaths for which medicine has been unable to do anything.
