Surgical Damage Control training with non-governmental organisations in Ukraine and Armenia.

In the event of armed conflict on national territory, terrorist attacks or disasters, any surgeon, civilian or military, whatever his specialty, could be confronted with the care of casualties caused by weapons of war, either individually or in a mass casualties situation. The surgeon must then use the tactics and techniques of Damage Control Surgery, not always well known to surgeons not regularly involved in Trauma care. In 2023, as part of our work with Non-Governmental Organizations, we set up a short course for Damage Control Surgery in Ukraine (ACDCS - Advanced Course for Damage Control Surgery), modelled on a course created in France following the terrorist attacks in Paris in 2015. We report the results of this 2 or 3-day course including theoretical training and simulation exercises. After an initial training of trainers, the courses were run in Lviv and Kharkiv by Ukrainian trained trainers with our pedagogical and logistical support. 69 courses trained 418 civilian and military surgeons. A study of the auditors' evaluation by means of pre- and post-tests (10 questions) confirms a lack of knowledge of certain surgical Damage Control techniques, and a clear increase in knowledge of these techniques after the course. An evaluation of audience satisfaction shows that 93% found the course very useful, and 81% felt they had discovered many new things. Armenia faced a high-intensity conflict on home territory in 2020. There was a demand for training in war surgery. We were able to set up an ACDCS in Yerevan in 2024, following the same procedures as in Ukraine. Thirteen courses were organized, training 93 surgeons.