Providing specialized surgical care to children affected by earthquakes.

This study is based on experience in providing specialized surgical care to 244 children with open soft tissue and bone injuries resulting from earthquakes in Pakistan (2005), Indonesia (2006 and 2009), Haiti (2010), Nepal (2015), and Myanmar (2025). The paper presents the principles for forming, deploying, and operating a mobile specialized pediatric team from the Clinical Research Institute of Emergency Pediatric Surgery and Traumatology - Dr. Roshal's Clinic in disaster-affected regions. It describes the process of establishing specialized pediatric surgical centers within surviving healthcare facilities and concentrating the most severe cases there. The study identifies errors made during primary and specialized care provision before the arrival of the mobile pediatric team. The effectiveness of treatment methods for open soft tissue and bone injuries with complicated wound healing processes has been analyzed. BACKGROUND: This study summarizes the experience of providing specialized surgical care to children in earthquake-affected zones, with particular focus on medical evacuation organization and adaptation of treatment protocols to disaster conditions. AIMS: To improve strategies and tactics for surgical treatment of children during mass casualty events following 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 demonstrated favorable treatment outcomes, including stable fixation of bone fragments, restoration of normal limb length, and complete fracture consolidation. CONCLUSIONS: The developed strategy for specialized surgical care and comprehensive approach to treating 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.