HWN Suggests

Trauma Surgery: Discipline in Crisis

A quarter century of progress has fundamentally altered the premises underlying the surgical paradigm of trauma. Dramatic advances in the speed and resolution of computed tomography have largely replaced “exploratory” surgery; indeed, even in the setting of radiographically documented intra-abdominal injury, most patients can now be safely treated nonoperatively. The practice of trauma surgery has transitioned from the invigoration of frequent “emergency” laparotomies to... Some trauma surgeons propose to reinvigorate their field by redefining it as “Acute Care Surgery.” Specifically, this makeover would expand their operative scope to include selected neurosurgical and orthopedic trauma procedures…

read full article

Featured

 The New Specialty of Acute Care Surgery:

How does Acute Care Surgery benefit the hospital and community? In the eyes of the hospital, the acute-care surgeon can fit into many roles: as a trauma surgeon who fulfills the 24 hour-7 day a week requirements; as an intensivist who manages the critically ill and injured; and as a general surgeon who can ameliorate the problem of the paucity of general surgeons taking emergency room call. All of these roles are fully integrated into the specialty of acute-care surgery.

Articles of Interest

Best Medical Schools for Trauma Surgery

Many good medical schools offer great residency programs for trauma surgery. We have listed some of the top-performing medical schools with this specialization.

State of the Art in Acute Care Surgery: Application, Innovation, and Future Perspectives

In the past decade, acute care surgery has undergone significant evolution, embracing advanced technologies and innovative methodologies that significantly enhance patient outcomes. The discipline integrates the principles of trauma surgery, emergency general surgery, and surgical critical care. Recently, the adoption of cutting-edge approaches like damage control surgery, management of the open abdomen, and advancements such as negative pressure wound therapy and point-of-care ultrasound have greatly enriched the specialty's efficacy.

The Choices We Make: Ethical Challenges in Trauma Surgery

Ethical issues in trauma surgery are commonplace but scarcely studied. We aim to characterize the ethical dilemmas trauma surgeons encounter in clinical practice, describe perceptions about the ability to manage these dilemmas, and strategies they use to address them.

The Future of Trauma Surgery

Examples include the suggestion that trauma surgery was born out of concepts generated during the past quarter century; in fact, trauma surgery and much of surgery in general is rooted in military medicine dating back many centuries. The strong linkage between trauma and surgical care is also evident in the bedrock of basic research on shock, blood banking and infection that grew out of the experience of surgeons in military conflicts. Trauma systems designed to facilitate optimal care for trauma patients in the early 1970s had less to do with the dominance of surgical personalities and more to do with triage networks (including aero medical transport) developed in Korea and Vietnam.

The U.S. trauma surgeon's current scope of practice: can we deliver acute care surgery?

The model of the acute care surgeon is attractive and timely, but only a limited number of trauma surgeons currently practice this proposed range of operative procedures; even fewer surgeons have an elective surgical practice to maintain key operative skills. Fellowship training programs need to incorporate vascular and thoracic procedures to enable the specialty of acute care surgery.

Resources

American Association for the Surgery of Trauma

The premier scholarly organization for surgeons dedicated to the field of trauma and the care of critically ill surgical patients.

Journal of Trauma and Acute Care Surgery

​​​​​​The Journal of Trauma and Acute Care Surgery® is designed to provide the scientific basis to optimize care of the severely injured and critically ill surgical patient.