The deployment of the Dutch Armed Forces in Afghanistan between 2001-2014, had an enormous impact on their organization and personnel. Lessons learned during and after this deployment can help the military medical support organization in improving logistics, administration of, and medical care delivered to service members that sustain injuries during ongoing and future assignments. During the International Security Assistance Force mission between 2006-2010, the Dutch Armed Forces were lead nation in the Uruzgan province, Afghanistan. On their main operating base, the Multinational Base in Tarin Kowt, a Role 2 Enhanced Medical Treatment Facility was operated under Dutch command were a variety of patients and injuries were treated. The deployed surgeon must be aware of and be prepared for being confronted with injuries far beyond the scope of a normal civilian practice. Limited resources, hostile environments, harsh climatological conditions and sometimes long evacuation times, attribute to working conditions that require an unprecedented combination of competences. Future military surgeons will therefore need a wide surgical skillset that is different from, and broader than the skillset that is needed in the highly specialized civilian environment of present day. Damage control surgery plays a prominent role in stabilizing a patient (hemorrhage and contamination control) before being evacuated from zones of combat and subsequently out of theater where more specialist and definitive care can be provided. Although timely evacuation is important, the right care for the right patient on the right time is a justifiable procedure to optimize patient outcome and quality of life. A major challenge for the future military surgeon is to seek ways to maintain essential skills and expertise when exposure to combat situations decreases. The military healthcare organization must be aware of these challenges and provide formalized training and exercise curricula that will benefit military surgeons in maintaining their ...