Épidémiologie des blessés de guerre français en Afghanistan : de la blessure à la réinsertion.

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Conference: Urgences 2015 - Congrès de la Société Française de Médecine d'Urgence, At Paris, Volume: Chapitre 83
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Abstract
Les treize années de présence française en Afghanistan ont été marquées par le caractère asymétrique du conflit et l'intensité de l'engagement opérationnel. Les explosions étaient le principal mécanisme lésionnel et les engins explosifs improvisés le principal agent vulnérant. Les membres et la région céphalique étaient les deux principales régions anatomiques lésées. La plupart des militaires blessés par engins explosifs, armes à feu et/ou dans des accidents de transport militaire étaient des traumatisés mineurs. L'amélioration de la prise en charge des blessés à l'avant a entraîné la survie de blessés plus graves présentant des traumatismes multiples et complexes à l'origine de séquelles sévères et nécessitant une longue prise en charge multidisciplinaire. La formation de tous les combattants au sauvetage au combat et l’initiation précoce des procédures de damage control ont permis de réduire les décès potentiellement évitables. Les états de stress posttraumatiques, les douleurs chroniques et les infections des plaies ont fréquemment compliqué les blessures physiques et retardé la réinsertion. Malgré une très forte mobilisation institutionnelle et associative autour du blessé de guerre, la réinsertion familiale, sociale et professionnelle était souvent longue et difficile. Le Service de santé des armées ne dispose actuellement pas de registre des traumatisés en opérations. Il est pourtant urgent qu’il s’en dote afin d’acquérir l’expertise médicale pertinente nécessaire à l’amélioration de ses pratiques et de valoriser ses savoir-faire.
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