Russia’s full-scale invasion of Ukraine has transformed both the modern battlefield and the microbial environment surrounding the war-wounded. Explosive injuries, prolonged evacuation, and limited opportunities for early decontamination have contributed to an unprecedented rise in multidrug-resistant organism (MDRO) infections. This paper describes how routine infection prevention and control (IPC) and antimicrobial stewardship (AMS) systems have become inadequate under conflict conditions and how contamination evolves into colonization and then systemic infection as casualties move through the evacuation pathway. Building on the national IPC and AMS strengthening, we outline a complementary crisis intervention: the application of chemical, biological, radiological, and nuclear-inspired decontamination principles to routine trauma care. These measures incorporate structured early irrigation and debridement, antiseptic cleansing, removal of contaminated materials, and the use of dedicated decontamination spaces at hospital entry. They
are designed to reinforce existing programs by reducing microbial burden at the earliest point of contact. Implementing this approach aims to disrupt MDRO acquisition and transmission, protect fragile healthcare infrastructure, and mitigate escalating biosecurity risks. Ukraine’s conflict experience has informed the
development of this proposed concept, with formal implementation and impact evaluation planned as thenext phase of work.

Introduction Ukraine’s health and trauma system has been detrimentally impacted since the Russian Federation invasion in February 2022. The number and extent of injuries experienced in Ukraine because of trench warfare and high-intensity large-scale combat operations has not been seen in recent conflicts. Understanding attitudes and perceptions around the use of devices and products including MOVES (monitor, oxygen concentrator, ventilator, and suction system) and its use in the large-scale combat operation environment can inform lessons learned for improved prehospital care in Ukraine, as well as in other future conflicts. Material and Methods We conducted qualitative key informant interviews with military and civilian Ukrainian health care workers during the ongoing conflict using an expanded version of the Global Trauma System Evaluation Tool. We focused the analysis on identifying and understanding the capability of MOVES Micro-integrated Life Support System (SLC). Results Thirty-six participants were interviewed; 56% were military and 44% were civilians and representative of all NATO roles or levels of care. Sixty-one percent of participants were male. Seventy-two percent of participants were stationed in the Eastern and Northern regions. The mean age was 34.9 years. Sixty-seven percent of care providers reported using MOVES SLC and the remainder stated they wanted the device. The device was sometimes referenced as a “portable ventilator.” Of other donated surgical equipment, MOVES SLC was described as “unique.” A stabilization modification was suggested as a need given the ad hoc vehicles used for en-route critical care. Participants reacted positively to using MOVES SLC and the capabilities and improvements in care that MOVES SLC can provide for en-route care of critically injured patients. Conclusions MOVES SLC is well regarded by Ukrainian trauma care providers. Training may be necessary to increase the quality of care when utilizing these devices, and vehicle modifications may be necessary for use given some concerns over the equipment falling during transport. There is a need to study how this equipment improves the ability of limited medical personnel to provide prolonged care for a larger number of patients with reduced medical resupply.