德国兰施图尔地区医疗中心美国军事高级访问外科医生项目的行动后总结报告。

A concluding after-action report of the Senior Visiting Surgeon program with the United States Military at Landstuhl Regional Medical Center, Germany.

机构信息

From the University of California (M.M.K.), San Francisco, California; Institute of Surgical Research (T.W.E.), Fort Sam Houston, Texas; US Air Force C-Stars (R.F.), Baltimore; and US Combat Casualty Care Research Program (T.E.R.), Fort Detrick, Maryland; Landstuhl Regional Trauma Center (KM), Landstuhl, Germany; University of Cincinnati (W.D.), Cincinnati, Ohio; Heart and Vascular Center (D.L.G.), New Beford, Massachusetts; University of Virginia (K.L.C.), Charlottesville, Virginia.

出版信息

J Trauma Acute Care Surg. 2014 Mar;76(3):878-83; discussion 883. doi: 10.1097/TA.0000000000000159.

DOI:10.1097/TA.0000000000000159

PMID:24553564

Abstract

BACKGROUND

The Senior Visiting Surgeon (SVS) program at Landstuhl Regional Medical Center (LRMC), Germany, was developed during the wars in Afghanistan and Iraq as a measure to build military-civilian interaction in trauma care and research. The objective of this study was to provide a summary of the program including workload and experiences. An additional objective was to identify factors needed for sustainment of this program during an interwar period.

METHODS

An electronic, 34-question survey was distributed to 192 surgeons who participated in the SVS program at LRMC, either through the American Association for the Surgery of Trauma or the Society of Vascular Surgery between 2005 and 2012. The survey was composed of multiple-choice and open-ended questions.

RESULTS

The response rate was 61% (n = 118), with 24% (n = 28) indicating previous military service. These 117 respondents provided 24.5 months of volunteer coverage at LRMC, with 22% (n = 26) performing multiple, 2-week rotations. Visiting surgeons participated in two to five operative cases per week, with the majority of operations related to the management of soft tissue wounds and burns followed by abdominal and vascular procedures, conducted daily multidisciplinary intensive care unit rounds, and collaborated with military surgeons in research projects resulting in 22 publications. More than half (n = 59) of the respondents maintained contact with military colleagues during the 12 months following the rotation. The majority of surveyed surgeons support continuation of the SVS at military facilities in the United States and hosting military surgeons at their civilian trauma center.

CONCLUSION

This study is the first to quantify the SVS program during the wars in Afghanistan and Iraq. Visiting surgeons provided more than 2 years of combat casualty care during these, the longest wars in US history. Continuation of this program will require expanded military-civilian interaction in trauma care, training, and research during any interwar period.

摘要

背景

德国兰施图尔地区医疗中心（LRMC）的高级访问外科医生（SVS）项目是在阿富汗和伊拉克战争期间作为加强创伤护理和研究中军民互动的一项措施而开发的。本研究的目的是总结该项目，包括工作量和经验。另一个目标是确定在两次战争之间维持该项目所需的因素。

方法

对 192 名曾于 2005 年至 2012 年期间通过美国创伤外科学会或血管外科学会参加 LRMC 的 SVS 项目的外科医生进行了一项电子的 34 个问题的调查。调查由多项选择题和开放式问题组成。

结果

回复率为 61%（n=118），其中 24%（n=28）有过军事服务经历。这 117 名受访者在 LRMC 提供了 24.5 个月的志愿者服务，22%（n=26）进行了多次为期两周的轮班。访问外科医生每周参与 2 到 5 例手术，大多数手术与软组织伤口和烧伤的管理有关，其次是腹部和血管手术，每天进行多学科重症监护病房查房，并与军事外科医生合作进行研究项目，发表了 22 篇论文。超过一半（n=59）的受访者在轮班结束后的 12 个月内与军事同事保持联系。大多数接受调查的外科医生支持在美国军事设施继续开展 SVS，并在他们的民用创伤中心接待军事外科医生。