While on a nine-month tour in Afghanistan, a small group of Fort Carson, Colo., soldiers revolutionized how the Army treats wounded troops.
The 29-member 2nd Forward Surgical Team was tied to special forces troops and had to come up with a way to treat casualties as American hospitals and bases closed, putting patients farther away from care. To solve the problem, the team broke into five-soldier detachments to take treatment to the troops.
"They had a 100 percent patient survival rate," said Col. James Andrews, commander of the 10th Combat Support Hospital that includes the surgical unit.
In a drive to leave Afghanistan by Dec. 31, U.S. commanders have closed dozens of bases in Afghanistan and sent thousands of troops home. But with the Taliban still active, combat wounds from bullets and bombs remain common, especially in the remote regions where special forces troops work.
To handle those injuries, the unit used a method now called "Golden Hour Offset Surgical-Transport Teams."
"It's mainly for expeditionary use," said Maj. John Kim, who led the unit in Afghanistan. Kim and his comrades returned to Fort Carson on March 12.
Since 2003, the Army has perfected a medical system that uses helicopters and transport planes to rush troops to care. Soldiers wounded on the battlefield were treated at one of several hospitals in Iraq or Afghanistan and then flown to Europe for a higher level of care, often arriving in Germany within hours of their injury.
But those big field hospitals are leaving Afghanistan and the small teams were invented to fill the gap.
"Its purpose was to be a surgical platform that was highly mobile and capable of moving to an austere location where there was no surgical capabilities, and outside of the "Golden Hour" medical evacuation coverage area," an Army report on the unit's work says. "In addition, it would support the emerging and short duration missions of the special operations forces community."
The "Golden Hour" is a term used by trauma specialists to describe the tight timeline that can determine whether a patient lives or dies. Wounded troops who get to hospital-style treatment within an hour of their injury usually live. Outside the hour, the odds of survival decrease with every tick of the clock.
"What we do with the forward surgical team is push invasive surgery care forward," Andrews said.
The small teams, with two surgeons, two anesthesiologists and a combat medic would set up in remote locations with enough supplies to conduct five surgeries on two operating tables.
During the concept's first trial, a Fort Carson team tied in with an Afghan unit from Nov. 9-14 and treated five patients, including gunshot victims and a patient with a compound fracture. They all survived.
"It gives the soldiers a much higher survival rate," Andrews said.
It also pushes caregivers into the combat zone. During the deployment, five soldiers in the unit earned the Army's Combat Action Badge for facing enemy fire.
The surgical team's successes were noticed by commanders who awarded team members five Bronze Star Medals, 18 Army Commendation Medals and seven Army Achievement Medals.
For Kim, the accolades are great, but coming home from war for the last time is better. Twelve years of war have ended for the surgical team, which has been deployed to Afghanistan and Iraq several times to treat wounded troops.
"It feels great," Kim said.