Decompressive craniectomy in casualties from OIF and OEF: Management after evacuation from the war zone

Care for the severe TBI patient who has undergone a decompressive craniectomy in a war zone does not end downrange. This life saving procedure is utilized to create a window of time that will allow relatively safe transport to higher echelons of care, where further treatment, complication management, and ultimately cranial reconstruction can take place. This chapter outlines the evacuation process and highlights management issues that have been seen when treating patients that were injured during Operation Iraqi Freedom and Operation Enduring Freedom.