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将创伤外科的未来重新定义为一项综合性创伤与急诊普通外科服务。

Redefining the future of trauma surgery as a comprehensive trauma and emergency general surgery service.

作者信息

Kim Patrick K, Dabrowski G Paul, Reilly Patrick M, Auerbach Susan, Kauder Donald R, Schwab C William

机构信息

Division of Traumatology and Surgical Critical Care, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.

出版信息

J Am Coll Surg. 2004 Jul;199(1):96-101. doi: 10.1016/j.jamcollsurg.2004.02.025.

Abstract

BACKGROUND

Dwindling operative opportunities in trauma care may have a detrimental impact on career satisfaction among trauma surgeons and on career attractiveness to surgical trainees. Addition of emergency general surgery may alleviate some of these concerns.

STUDY DESIGN

The trauma service at our institution incorporated nontrauma emergency general surgery over a 3-year period. The institution's trauma registry and hospital perioperative database were queried. The changes in operative caseload are described. Current trauma faculty anonymously completed a Web-based questionnaire about the addition of emergency general surgery to the trauma service.

RESULTS

Operations for trauma decreased in 2002 compared with 1999, despite a higher number of penetrating injuries and total trauma contacts. Nontrauma general surgery operations performed by trauma faculty increased in proportion to coverage provided by the trauma service. In 2002, 57% of all cases performed by trauma surgeons were emergency general surgery, which accounted for 32% to 74% of an individual surgeon's caseload. In anonymously completed Web-based questionnaires, current trauma faculty expressed satisfaction with the combined trauma and emergency general surgery model.

CONCLUSIONS

The combined trauma and nontrauma surgery service increased operative caseloads and improved satisfaction of trauma surgeons. A comprehensive trauma and emergency general surgery service may be an attractive model for the future of trauma surgery and provide logistical and medical advantages to the emergency general surgery patient population.

摘要

背景

创伤治疗中手术机会的减少可能会对创伤外科医生的职业满意度以及对外科住院医师的职业吸引力产生不利影响。增加急诊普通外科手术可能会缓解其中一些问题。

研究设计

我们机构的创伤服务部门在3年时间里纳入了非创伤性急诊普通外科手术。查询了该机构的创伤登记册和医院围手术期数据库。描述了手术病例数量的变化。目前的创伤科医生匿名完成了一份关于在创伤服务中增加急诊普通外科手术的网络调查问卷。

结果

与1999年相比,2002年创伤手术量有所下降,尽管穿透伤数量和创伤总接触量有所增加。创伤科医生进行的非创伤性普通外科手术量与创伤服务提供的覆盖范围成比例增加。2002年,创伤外科医生进行的所有病例中有57%是急诊普通外科手术,占单个外科医生病例量的32%至74%。在匿名完成的网络调查问卷中,目前的创伤科医生对创伤与急诊普通外科手术相结合的模式表示满意。

结论

创伤与非创伤性外科手术服务相结合增加了手术病例量,提高了创伤外科医生的满意度。全面的创伤与急诊普通外科手术服务可能是创伤外科未来一个有吸引力的模式,并为急诊普通外科患者群体提供后勤和医疗优势。

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