The peacetime trauma experience of U.S. Army surgeons: Another call for collaborative training in civilian trauma centers

Abstract

Objective: To document the ongoing trauma experience of U.S. Army surgeons during peacetime clinical practice. Methods: Surveys were mailed to the trauma directors of military surgical services worldwide. Questions focused on numbers of operative cases and availability of trauma resources. Laparotomy, thoracotomy, and vascular repair for trauma were considered index cases and simple means were computed based on numbers of cases per general surgeon. Results: Seventy percent of worldwide Army surgical services responded to the survey. In 1992, on the average, a general surgeon in the Army performed 1.3 trauma laparotomies, 0.3 thoracotomies, and 0.3 vascular repairs for trauma. Only 6 of 28 surgical services had an organized 'trauma team,' 3 held regular trauma conferences, and 1 service kept a registry and could calculate an average injury severity score. Conclusions: Our data support perceptions concerning lack of an ongoing trauma experience for military surgeons and reinforces the need for collaborative education and training in busy civilian trauma centers. A regional approach is suggested as a viable solution.