Kurihara Hayato
Chirurgia (Bucur). 2017 Sept-Oct;112(5):630-631. doi: 10.21614/chirurgia.112.5.630.
In 2008 Uranues published the results of a questionnaire sent to experts across 27 European countries on the assessment of attitudes toward acute care surgery and he concluded that no unified system of acute care surgery in Europe was yet developed due to different approaches to the surgical critical patient and that, with exception of some dedicated centres, the intra-hospital resources were not dedicated to acute care surgery patients with consequent negative impact on ideal treatment both in the elective and acute patients (1). The problem in most of European countries is still the same: who is the best surgeon to deal with these patients with an acute surgical condition? The era of the "omnipotent general surgeon" is to an end and in order to improve quality in specific areas many institutions dedicate most of their economic resources to highly specialized surgical units; nowadays young committed surgeons are therefore attracted by the so-called "organ specific surgery" and take care of emergency surgery and trauma cases just because of a contractual obligation. The lack of subspecialty in trauma and acute care and the lack of interest in the treatment of such complex surgical and trauma cases did not give impetus to the development of clinical standards or professional accreditations guidelines causing a perfect storm with consequent provided care that is less than optimal.
2008年，乌拉诺斯公布了一项对27个欧洲国家专家进行的关于急性护理手术态度评估的问卷调查结果。他得出结论，由于对手术重症患者的处理方式不同，欧洲尚未建立统一的急性护理手术系统。除了一些专门的中心外，医院内部资源并未专门用于急性护理手术患者，这对择期和急症患者的理想治疗产生了负面影响（1）。大多数欧洲国家的问题仍然相同：谁是处理这些急性外科疾病患者的最佳外科医生？“全能普通外科医生”的时代已经结束，为了提高特定领域的质量，许多机构将大部分经济资源投入到高度专业化的外科科室；因此，如今有抱负的年轻外科医生被所谓的“器官特异性手术”所吸引，只是出于合同义务才处理急诊手术和创伤病例。创伤和急性护理领域缺乏亚专业，以及对这类复杂外科和创伤病例治疗缺乏兴趣，没有推动临床标准或专业认证指南的发展，从而引发了一场完美风暴，导致所提供的护理不尽如人意。
