Fork from camping utensils as a wounded
shell caused severe vascular injury in a
combat patient injured in the war in Ukraine:
a case report

Fork from camping utensils as a wounded
shell caused severe vascular injury in a
combat patient injured in the war in Ukraine:
a case report

War in Ukraine, Unusual penetrating projectile, Camping utensil, Kitchen cutlery, Temporary arterial shunts,
Damage control surgery, Damage control resuscitation

Abstract
Background The war in Ukraine is associated with severe injuries and challenges in the management of patients.
There are various kinds of high-energy ballistic projectiles, but kitchen cutlery or camping utensils parts, such as forks,
knives, or spoons, are not usually expected to be found in the gunshot wound, but might serve as a ballistic projectile
causing severe damage to the human body. Vascular injury is also a challenge in war surgery, and the application of
temporary arterial shunts is a good approach, as well as the application of damage control tactics. The aim of this
study was to demonstrate the rare case of management of the combat patient who received a severe vascular injury
to the femoral artery by fork from camping utensils after the strike by the KAB precision-guided munition, who was
treated with temporary arterial shunts with application of DCR and DCS.
Case presentation A 34-year-old Ukrainian soldier was wounded by a precision-guided munition (KAB) in East
Ukraine. The injury resulted in severe trauma to the left lower extremity, including superficial femoral artery damage.
Due to the persistent threat of drone attacks, the rapid evacuation to advanced medical facilities was delayed for 12 h.
The Forward Surgical Team diagnosed the patient with arterial thrombosis of superficial femoral artery and a foreign
metal mass, identified as a fork, which was a part of a camping utensil, embedded in the hip. Surgical intervention
involved the removal of the foreign bodies and amputation below the upper third of the hip due to critical arterial
ischemia. The patient was stabilized, transferred to a higher-level field hospital, and eventually discharged after 21
days for rehabilitation and prosthetic fitting.
Conclusions The trajectory of a high-energy ballistic projectile might go through the various objects (e.g., cutlery
forks, etc.), followed by their involvement in the injury process, and increase the severity of the wounds. Ongoing war
in Ukraine is associated with the impossibility of wide use of the aeromedical evacuation due to tactical obstacles,
resulting in prolongation of the time for patients’ evacuation to higher level of medical care and higher risk for
extremity amputations in patients with vascular injury.

Igor Lurin1,2, Vitalii Makarov3,4, Volodymyr Nehoduiko3,4, Ivan Veryovkin5

, Maksym Malimonenko5

, Victor Orlov6
and

Andrii Dinets7,8*

https://doi.org/10.1186/s12245-025-01044-6

2025

Peri Irawan

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