The hidden war: humanitarian surgery in a combat zone.

Humanitarian surgical care (HSC) provided during wartime plays a substantial role in military operations, but has not been described or quantified beyond individual experiences.Prospective survey was conducted of all military members deployed to Iraq or Afghanistan between 2002 and 2011.There were 266 responses. On average, surgeons had been in practice for 3 years at their 1st deployment and the majority were not fellowship trained. HSC was performed on all body systems and patient populations, including surgery for malignancy. Although 30% of responders performed surgeries they had never done before as a staff surgeon, 84% felt well prepared by their residency. The majority felt that performing HSC improved unit readiness (60%), benefited local population (64%), and contributed to counterinsurgency operations (54%).Over our 10-year period, hundreds of military surgeons performed countless HSC cases in Iraq and Afghanistan and the majority felt that HSC had numerous benefits.