This article presents a clinical case of the successful treatment of a 35-year-old military serviceman who sustained combined shrapnel wounds to the chest and right upper limb in the zone of the Special Military Operation. The patient was diagnosed with a non-penetrating chest wound and a penetrating shoulder wound accompanied by a comminuted fracture. The patient also had an injury to the subscapular artery with a pulsating hematoma and a subclavian vein injury, the latter of which was detected during surgery. A single-stage surgical procedure was performed at a Level 2 field hospital. This procedure included surgical debridement, osteosynthesis of the shoulder fracture using a rod system, and vascular reconstruction. The vein and artery defects were closed using 6/0 sutures. The two-hour surgery resulted in 30 ml of blood loss. Postoperative recovery proceeded without complications, and the patient was evacuated for further treatment. Thus, this case demonstrates that complex vascular procedures can be performed effectively and safely during the early stages of medical evacuation in a conflict zone.