Combat amputee care for Global War on Terror Veterans: A systematic review

Abstract: Introduction: Traumatic amputation after injuries sustained from combat during the Global War on Terror resulted in a multitude of clinical outcomes that included physical and psychological complications. The U.S. Department of Veterans Affairs and U.S. Department of Defense instituted the Advanced Rehabilitation Centers (ARCs) in 2007 to help address the growing amputee service member population. This article seeks to determine how the current literature describes physical, mental, and social health outcomes for U.S. combat amputee service members since the development of the ARCs. Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following databases were searched for articles to screen: PubMed (NCBI), EMBASE (Elsevier), CINAHL Complete (EBSCOhost), and MEDLINE (EBSCOhost). The following key words were used: “traumatic amputation,” “amputee,” “Veteran,” and “military” to find articles published between 2007 and March 2023. Results: Amputee service members are at increased risk of detrimental health outcomes when compared to non-amputee service members. The timing of amputation has a significant impact on short- and long-term health outcomes. Research trends were focused on pain and pain management, comparisons to Vietnam Veteran amputees, prosthesis satisfaction and functionality, limb salvage, quality of life and mental health, and general health outcomes. Discussion: The treatment of amputee Veterans requires special consideration between short-term complications, long-term health outcomes, and psychological diagnoses to help increase quality of life.