Service de Chirurgie Viscérale et Vasculaire, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France.
Injury. 2012 Aug;43(8):1301-6. doi: 10.1016/j.injury.2012.03.002. Epub 2012 Mar 21.
To evaluate the activity of visceral surgeons assigned to the Medical Treatment Facility (MTF) (role 3) in Kabul International Airport (KAIA) and identify the skills and qualifications required by these specialists.
Between July 2009 and December 2010, all the patients operated by the visceral surgeons were eligible for inclusion in this study. They were International Security and Assistance Force (ISAF), Afghan National Security Forces (ANSF) soldiers, non-afghan civilians personnel and local nationals (LNs). They sustained war-related injuries, non-war related trauma emergencies, non-trauma related emergencies or had elective surgical care. The mechanisms and types of injuries, the affected organs and the surgical procedures were collected.
Over the period of study, the visceral surgeons treated 261 over 971 patients (26.9%) achieving a total of 438 surgical procedures. Thirty one percent of these procedures were war-related, 26% non-war related, 24.2% non-trauma related emergencies and 18.1% elective surgery. Non-trauma related emergencies and elective surgery required the same skills as in civilian practice. War-related injuries and non-war related trauma emergencies were more challenging. Combined injuries represented 56% of the cases requiring damage control resuscitation procedures and/or treatment of severe burns. Life-threatening thoracic or vascular injuries (30%) required life-saving emergency surgical procedures.
A visceral surgeon in a role 3 MTF should master a wide range of skills and expertise to be able to deal with many complex situations, in particular life-threatening situations such as thoracic and vascular wounds. A comprehensive surgical training programme for surgeons in abroad deployment (Advance Course for Deployment Surgery - CACHIRMEX) has been designed and settled up in 2007 to provide these necessary skills. The feedback obtained from each previous deployment demonstrates that the advanced course for deployment surgery provides visceral surgeons the necessary skills required to deliver surgical healthcare in a role 3 MTF. However, a regular assessment of this programme is mandatory to ensure that this training stays appropriate and contributes to better outcomes and a decreased mortality rate.
评估派驻喀布尔国际机场（KAIA）医疗救治设施（MTF）的内脏外科医生（角色 3）的工作情况，并确定这些专家所需的技能和资质。
2009 年 7 月至 2010 年 12 月期间，所有由内脏外科医生进行手术的患者均符合本研究纳入标准。他们是国际安全援助部队（ISAF）、阿富汗国家安全部队（ANSF）士兵、非阿富汗平民人员和当地国民（LN）。他们遭受了与战争相关的损伤、非战争相关的创伤急症、非创伤相关的急症或接受了择期手术治疗。收集了手术机制和类型、受伤器官和手术程序。
在研究期间，内脏外科医生共治疗了 261 名患者（26.9%），共完成了 438 例手术。其中 31%的手术与战争有关，26%与非战争有关，24.2%为非创伤相关急症，18.1%为择期手术。非创伤相关急症和择期手术需要与在平民实践中相同的技能。与战争有关的损伤和非战争相关的创伤急症更具挑战性。合并损伤占需要损伤控制复苏程序和/或严重烧伤治疗的病例的 56%。威胁生命的胸部或血管损伤（30%）需要进行挽救生命的紧急手术。
派驻在角色 3 MTF 的内脏外科医生应掌握广泛的技能和专业知识，以应对许多复杂情况，特别是威胁生命的情况，如胸部和血管创伤。2007 年，为在国外部署的外科医生设计并建立了一项全面的外科培训计划（部署外科高级课程 - CACHIRMEX），以提供这些必要技能。从每次部署中获得的反馈表明，部署外科高级课程为内脏外科医生提供了在角色 3 MTF 提供外科医疗保健所需的必要技能。然而，必须定期评估该计划，以确保该培训保持适当，并有助于改善结果和降低死亡率。
