Challenges in the training of military surgeons: experiences from Dutch combat operations in southern Afghanistan

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Rigo HoencampJaap F Hamming

Abstract

To improve care for battle casualties, we analyzed the surgical workload during the Dutch deployment to Uruzgan, Afghanistan. This surgical workload was compared with the resident surgical training and the pre-deployment medical specialist program. Patient data from the trauma registry (2006-2010) at the Dutch Role 2 Medical Treatment Facility (MTF) were analyzed. The case logs of chief residents (n = 15) from the general surgery training program in the Netherlands were used for comparison. The trauma registry query yielded 2,736 casualties, among whom 60 % (1,635/2,736) were classified as disease non-battle casualties and 40 % (1,101/2,736) as battle casualties. During the study period, 1,427 casualties (336 pediatric cases) required 2,319 surgical procedures. Each graduating chief resident handled an average of 1,444 cases, including 165 laparotomies, 19 major vessel repairs, 28 amputations, and 153 fracture stabilizations, during their residency. Residents had limited exposure to injuries requiring a thoracotomy, craniotomy, nephrectomy, IVC repair, or external genital trauma. The injuries treated at the Dutch Role 2 MTF were often severe, and exposure to pediatric cases was much higher than reported for other combat hospita...Continue Reading

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Citations

Aug 1, 2014·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·F Turégano, S Lennquist
May 15, 2015·International Orthopaedics·Oscar AlvaradoLynette Dominguez
Nov 10, 2017·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·H UchinoD L Clarke
Nov 16, 2018·Journal of the Royal Army Medical Corps·Dawei ZhangB Li
May 11, 2017·World Journal of Surgery·Grace BauhahnEdward C T H Tan
Dec 13, 2019·World Journal of Emergency Surgery : WJES·Frederike J C HaverkampEdward C T H Tan
Jul 28, 2017·World Journal of Surgery·H UchinoD L Clarke
Jun 11, 2020·The Journal of Trauma and Acute Care Surgery·Guy JensenJoseph Galante
May 30, 2020·The Journal of Trauma and Acute Care Surgery·Caryn A SternJennifer M Gurney

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