A specialized surgical care to children-victims of earthquakes

BACKGROUND: The article describes the authors’ experience in providing a specialized surgical care to 247 children-victims with open soft tissue and bone injuries resulting of earthquakes in Pakistan (2005), Indonesia (2006 and 2009), Haiti (2010), Nepal (2015), and Myanmar (2025). The paper presents principles for formation, deployment and operation of a mobile specialized pediatric team from the Clinical Research Institute of Emergency Pediatric Surgery and Trauma—Dr. Roshal's Clinic (Moscow, Russia) in disaster-affected regions. It describes the process of establishing specialized pediatric surgical centers at undamaged healthcare facilities and concentrating the most severe cases there. The study identifies errors made during the primary and specialized care provision before the arrival of the mobile pediatric team. The effectiveness of curative techniques for open soft tissue and bone injuries with complicated wound healing processes has been analyzed. AIM: To improve strategies and tactics for surgical treatment of children during mass casualty events after earthquakes. METHODS: A prospective non-randomized clinical study was conducted, analyzing diagnostic results and comprehensive surgical treatment outcomes in 247 pediatric patients with open injuries sustained during earthquakes across various countries. RESULTS: All clinical cases have demonstrated favorable treatment outcomes, including stable fixation of bone fragments, restoration of normal limb length, and complete fracture consolidation. CONCLUSION: This trial summarizes the authors’ experience on providing specialized surgical care to children in earthquake-affected zones, with a particular focus on medical evacuation organization and adaptation of treatment protocols to disaster situations. The developed strategy for specialized surgical care and comprehensive approach to managing open soft tissue and bone injuries yielded significant clinical results. Early reconstructive and plastic surgical interventions ensured anatomical integrity restoration and functional recovery in all pediatric patients, providing satisfactory rehabilitation potential for their future life.