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Retrospective analysis of tourniquet use and evacuation times in combat settings, highlighting challenges posed by drones.
INTRODUCTION: The widespread deployment of tactical drones in modern warfare has fundamentally altered battlefield conditions and medical evacuation protocols. This study examines the impact of drone warfare on tourniquet application and care of personnel with extremity hemorrhages. MATERIALS AND METHODS: We conducted a retrospective comparative analysis of patients treated with hemostatic tourniquets at Forward Surgical Teams (FST) during 2 defensive operations: January-April 2025 (drone warfare era) versus 2016 (pre-drone era). Primary outcomes included evacuation times, tourniquet effectiveness, and clinical outcomes. RESULTS: 80 patients with extremity tourniquets were treated in 2025 versus 69 in 2016. Over 60% of patients in 2025 arrived beyond the safe tourniquet timeframe (>3 hours) compared to 15% in 2016. Drone-related injuries accounted for 65% of cases in 2025. Ineffective tourniquet application increased from 17.4% (2016) to 37.5% (2025). Medical evacuation stages were forced to relocate 10-15 km further from the contact lines because of drone threats. CONCLUSIONS: Tactical drone warfare significantly impairs medical evacuation efficiency and increases complications from prolonged tourniquet application. These findings highlight the urgent need for alternative hemorrhage control methods and adapted evacuation protocols for modern combat environments.
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Yatsun et al. (2026) studied this question.
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