Bush Ruth L, Fairman Ronald M, Flaherty Stephen F, Gillespie David L
Division of Vascular Surgery, Scott & White Hospital, Texas A & M University Health Science Center, Temple, Texas 76508, USA.
J Vasc Surg. 2009 Jan;49(1):226-9. doi: 10.1016/j.jvs.2008.09.015.
With a shortage of active duty vascular surgeons in the military, Society for Vascular Surgery (SVS) members have been called upon to perform short-term rotations at Landstuhl Regional Medical Center (LRMC), the US military's receiving facility for combat injuries sustained in the Iraq and Afghanistan conflicts. From September 2007 to May 2008, 20 SVS vascular surgeons have performed 2-week rotations at LRMC through American Red Cross and US Army sponsorship. Volunteers were surveyed for previous military and/or trauma experience. In addition to reporting number and types of procedures performed, volunteers were queried on their experience and impression of the rotation. Several volunteers have had prior military experience and all have had vascular trauma experience through residency, fellowship, and current practices. With most definitive vascular repairs being done in theater, SVS members were most often called upon for clinical expertise in the care of combat casualties and evaluation of revascularization procedures. The volunteers contributed to daily rounds, patient care, and teaching conferences, as well as actively participated in surgical procedures with the most common being wound examinations under anesthesia for which intraoperative vascular consultation was occasionally requested (5-20 per volunteer). Additional procedures that volunteers performed included: inferior vena cava (IVC) filter placement, thrombectomy, revision of lower and upper extremity interposition vein grafts, retroperitoneal spine exposures, diagnostic and therapeutic angiograms, iliac stenting, and duplex ultrasound scan interrogation of vascular repairs, suspected arterial injuries, and deep vein thrombosis. All volunteers described the experience as valuable and will return if needed. With a limited number of military vascular surgeons and the unpredictable need for a vascular specialist at LRMC, civilian volunteers are playing an important role in providing high-quality vascular care for the nation's wounded soldiers by expanding vascular and endovascular capability at LRMC and contributing to general surgical critical care. As volunteers, SVS members are carrying on a tradition started by our surgical forefathers during previous US military conflicts.
由于军队现役血管外科医生短缺，血管外科学会（SVS）的成员被要求在美国兰施图尔地区医疗中心（LRMC）进行短期轮值工作，该中心是美军接收在伊拉克和阿富汗冲突中遭受战斗创伤人员的医疗机构。2007年9月至2008年5月，20名SVS血管外科医生在美国红十字会和美国陆军的资助下，在LRMC进行了为期两周的轮值工作。对志愿者进行了有关先前军事和/或创伤经验的调查。除了报告所实施手术的数量和类型外，还询问了志愿者对轮值工作的经验和印象。一些志愿者有过先前的军事经验，并且所有人都通过住院医师培训、专科培训和当前的工作经历有过血管创伤方面的经验。由于大多数确定性血管修复手术在战地进行，SVS成员最常被要求在战斗伤员护理和血管重建手术评估方面提供临床专业知识。志愿者参与日常查房、患者护理和教学会议，还积极参与外科手术，最常见的是在麻醉下进行伤口检查，偶尔会要求进行术中血管会诊（每位志愿者5 - 20次）。志愿者实施的其他手术包括：下腔静脉（IVC）滤器置入、血栓切除术、下肢和上肢间置静脉移植物修复、腹膜后脊柱暴露、诊断性和治疗性血管造影、髂动脉支架置入，以及对血管修复、疑似动脉损伤和深静脉血栓形成进行双功超声扫描检查。所有志愿者都认为这段经历很有价值，并表示如有需要愿意再次前往。由于军事血管外科医生数量有限，且LRMC对血管专科医生的需求不可预测，平民志愿者通过扩大LRMC的血管和血管内治疗能力并参与普通外科重症护理，在为美国受伤士兵提供高质量血管护理方面发挥着重要作用。作为志愿者，SVS成员正在传承我们的外科先辈们在美国先前军事冲突期间开创的传统。
