In this article, Giovanni Dall’Amico discusses the delivery of limb reconstruction in resource-constrained healthcare systems. Healthcare providers under pressure can learn a great deal from conflict zones and Giovanni shares some valuable insights.
At the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) Winter Scientific Meeting in Belfast in December 2025, Mr Ahmed El Mokhallalati and I presented two complementary studies examining lower-limb reconstruction during the Gaza conflict and subsequent humanitarian evacuations aboard the Italian Navy hospital ship Nave Vulcano.
Although geographically and operationally distinct, these experiences represent two ends of the reconstructive spectrum: active bombardment within a collapsing civilian healthcare infrastructure, and a structured but capacity-limited maritime Role-2/2LM hospital platform operating under military-humanitarian governance. Together, they offer a unique lens through which to examine how reconstructive trauma care can be delivered when systems are under extreme strain.
What emerged was not a narrative of improvisation in chaos, but one of disciplined adaptability anchored firmly in surgical fundamentals. The lessons are not confined to conflict zones. They are increasingly relevant to modern health systems facing workforce shortages, supply chain disruption, infrastructure pressure, and rising demand.
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