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Erschienen in: European Journal of Trauma and Emergency Surgery 4/2014

01.08.2014 | Original Article

Challenges in the training of military surgeons: experiences from Dutch combat operations in southern Afghanistan

verfasst von: R. Hoencamp, E. C. T. H. Tan, F. Idenburg, A. Ramasamy, T. van Egmond, L. P. H. Leenen, J. F. Hamming

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 4/2014

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Abstract

Background

To improve care for battle casualties, we analyzed the surgical workload during the Dutch deployment to Uruzgan, Afghanistan. This surgical workload was compared with the resident surgical training and the pre-deployment medical specialist program.

Methods

Patient data from the trauma registry (2006–2010) at the Dutch Role 2 Medical Treatment Facility (MTF) were analyzed. The case logs of chief residents (n = 15) from the general surgery training program in the Netherlands were used for comparison.

Results

The trauma registry query yielded 2,736 casualties, among whom 60 % (1,635/2,736) were classified as disease non-battle casualties and 40 % (1,101/2,736) as battle casualties. During the study period, 1,427 casualties (336 pediatric cases) required 2,319 surgical procedures. Each graduating chief resident handled an average of 1,444 cases, including 165 laparotomies, 19 major vessel repairs, 28 amputations, and 153 fracture stabilizations, during their residency. Residents had limited exposure to injuries requiring a thoracotomy, craniotomy, nephrectomy, IVC repair, or external genital trauma.

Conclusions

The injuries treated at the Dutch Role 2 MTF were often severe, and exposure to pediatric cases was much higher than reported for other combat hospitals in Iraq and in Afghanistan. The current civilian resident training does not equip the trainees with the minimally required competences of a fully trained military surgeon. The recognition in the Netherlands of military surgery as a subspecialty within general (trauma) surgery, with a formal training curriculum, should be considered. The introduction of a North Atlantic Treaty Organization Military (and Disaster) Surgery standard may facilitate the achievement of this aim.
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Metadaten
Titel
Challenges in the training of military surgeons: experiences from Dutch combat operations in southern Afghanistan
verfasst von
R. Hoencamp
E. C. T. H. Tan
F. Idenburg
A. Ramasamy
T. van Egmond
L. P. H. Leenen
J. F. Hamming
Publikationsdatum
01.08.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 4/2014
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-014-0401-z

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