Current US Military Operations and Implications for Military Surgical Training

Tyler, Joshua A.; Clive, Kevin S.; White, Christopher E.; Beekley, Alec C.; Blackbourne, Lorne H.

doi:10.1016/j.jamcollsurg.2010.07.009

Cited by 32 publications

(4 citation statements)

References 9 publications

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“…7,8 The objectives of this study are to compare and contrast the head and neck trauma experience in Iraq and Afghanistan and to identify trauma lessons learned that are applicable to civilian practice. 9,10…”

Section: Introductionmentioning

confidence: 99%

Head and neck trauma in Iraq and Afghanistan: Different war, different surgery, lessons learned

Brennan

2013

The Laryngoscope

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Objectives/Hypothesis: The objectives are to compare and contrast the head and neck trauma experience in Iraq and Afghanistan and to identify trauma lessons learned that are applicable to civilian practice.Study Design: A retrospective review of one head and neck surgeon's operative experience in Iraq and Afghanistan was performed using operative logs and medical records.Methods: The surgeon's daily operative log book with patient demographic data and operative reports was reviewed. Also, patient medical records were examined to identify the preoperative and postoperative course of care.Results: The head and neck trauma experiences in Iraq and Afghanistan were very different, with a higher percentage of emergent cases performed in Iraq. In Iraq, only 10% of patients were pretreated at a facility with surgical capabilities. In Afghanistan, 93% of patients were pretreated at such facilities. Emergent neck exploration for penetrating neck trauma and emergent airway surgery were more common in Iraq, which most likely accounted for the increased perioperative mortality also seen in Iraq (5.3% in Iraq vs. 1.3% in Afghanistan). Valuable lessons regarding soft tissue trauma repair, midface fracture repair, and mandible fracture repair were learned.Conclusion: The head and neck trauma experiences in Iraq and Afghanistan were very different, and the future training for mass casualty trauma events should reflect these differences. Furthermore, valuable head and neck trauma lessons learned in both war zones are applicable to the civilian practice of trauma.

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Section: Introductionmentioning

confidence: 99%

Head and neck trauma in Iraq and Afghanistan: Different war, different surgery, lessons learned

Brennan

2013

The Laryngoscope

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“…The latter also provides the only exposure to the hepatic and pancreatic techniques listed. Surgical subspecialisation further limits surgical trainees’ exposure to the non-abdominal techniques in Table 1, a problem reflected in US experience 11. In particular, the formal separation of vascular from general surgery will require the DMS either to establish and deploy parallel cadres or to provide additional training to allow surgeons from one cadre to be credentialed in the militarily relevant elements of the other.…”

Section: The Needmentioning

confidence: 99%

Maintaining surgical skills for military general surgery: the potential role for multivisceral organ retrieval in military general surgery training and practice: Table 1

O’Reilly¹,

Lordan

Streets³

et al. 2015

J R Army Med Corps

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The closure of the Medical Treatment facility in Camp BASTION and the return to contingency operations presents a new challenge in training and maintaining the skills of military surgeons. Multivisceral organ retrieval presents a unique opportunity to practice some of the more unusual techniques required in military surgery in the National Health Service. This article details the experience that organ retrieval offers and matches this to the needs of military surgeons. National Organ Retrieval Service teams need skilled surgeons, and a mutually beneficial partnership is in prospect.

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“…3 Whether military or civilian, the isolated surgeon must be prepared to treat rarebut-real surgical emergencies until life-threatening conditions are stabilized and transport is arranged. [4][5][6] With each new patient presentation, the isolated surgeon must critically evaluate the health care system's capability for the care that patient requires. A key concept in surgical training is contingency planning; that is, answering questions such as: "How can this operation fail, and can I handle that complication?…”

Section: Introductionmentioning

confidence: 99%

The Isolated Surgeon: A Scoping Review

Nealeigh

Kucera

Artino

et al. 2021

Journal of Surgical Research

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Background: Surgeons in resource-limited environments often provide care outside the expected scope of current general surgery training. Geographically isolated patients may be unwilling or unable to travel for specialty care. These same patients also present with lifethreatening emergencies beyond the typical breadth of a general surgeon's practice, in hospitals with limited professional and material support. This review characterizes the unique role of isolated surgeons, so individual surgeons and health care organizations may focus professional development resources more efficiently, with the ultimate goal of improved patient care.Methods: We performed a scoping review of the isolated surgeon, reviewing 25 years of literature regarding isolated US civilian and military surgeons. We examined emerging themes regarding the definition of an isolated surgeon, the scope of surgical practice beyond current training norms, and training gaps identified by surgeons in an isolated role.Results: From 904 articles identified, we included 91 for final review. No prior definition exists for the isolated surgeon, although multiple definitions describe rural surgeons, patients, or hospitals; we propose an initial definition from consistent themes in the literature. Isolated surgeons across varied practice settings consistently performed relatively large volumes of cases of, and identified training gaps in, orthopedic, obstetric and gynecologic, urologic, and vascular surgery subspecialties. Life-threatening, "rare-but-real" cases in the above and neurosurgical disciplines are uncommon, but consistent across practice settings.Conclusions: This review represents the largest examination of the isolated surgeon in the current literature. Clarifying the identity, practice components, and training gaps of the

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Current US Military Operations and Implications for Military Surgical Training

Cited by 32 publications

References 9 publications

Head and neck trauma in Iraq and Afghanistan: Different war, different surgery, lessons learned

Head and neck trauma in Iraq and Afghanistan: Different war, different surgery, lessons learned

Maintaining surgical skills for military general surgery: the potential role for multivisceral organ retrieval in military general surgery training and practice: Table 1

The Isolated Surgeon: A Scoping Review

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