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European Surgery

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24-04-2023 | Vascular Trauma | main topic

Training in vascular trauma surgery for non-vascular surgeons

Vascular trauma surgery skills course

Authors: M. Engelhardt, R. Schmid, B. Kölbel, A. Hyhlik-Dürr, S. Zerwes, C. Zischek

Published in: European Surgery | Issue 3-4/2023

Summary

Background

The experience of general and trauma surgeons in vascular trauma management has decreased with sub-specialization of surgery and working hours restrictions. We introduce a vascular trauma surgery skills course established to train German military surgeons prior to their deployment to conflict areas.

Methods

The intention and implementation of the vascular trauma course for non-vascular surgeons is described in detail.

Results

In hands-on courses, participants learn and train basic vascular surgical techniques on more realistic extremity, neck, and abdominal models with pulsatile vessels. A fundamental and an advanced course each provide military as well as civilian surgeons from different non-vascular specialties with a surgical skill set including direct vessel sutures, patch angioplasty, anastomosis, thrombectomy, and resuscitative endovascular balloon occlusion of the aorta (REBOA) in order to render them capable of managing major vascular injuries.

Conclusion

The experiences of this vascular trauma surgical skills course, initially established for military surgeons, can also be of use to all civilian general, visceral, and trauma surgeons occasionally facing traumatic or iatrogenic vascular injuries. Thus, the introduced vascular trauma course is valuable for all surgeons working in trauma centers.

Barmpara G, Inaba K, Talving P, et al. Pediatric vs adult vascular trauma: a nation trauma databank review. J Pediatr Surg. 2010;45(7):1404–12. https://doi.org/10.1016/j.pedsurg.2009.09.017.CrossRef

Heldenberg E, Givon A, Simon D, Bass A, Almogy G, Peleg K. Civilian casualties of terror-related explosions: the impact of vascular trauma on treatment and prognosis. J Trauma Acute Care Surg. 2016;81(3):435–40. https://doi.org/10.1097/TA.0000000000001123.CrossRefPubMed

Franz RW, Shah KJ, Halaharvi D, Franz ET, Hartman JF. A 5‑year review of management of lower extremity arterial injuries at an urban level I trauma center. J Vasc Surg. 2011;53(6):1604–10. https://doi.org/10.1016/j.jvs.2011.01.052.CrossRefPubMed

Bowley DMG, Degiannis E, Goosen J, Boffard KD. Penetrating vascular trauma in Johannesburg, South Africa. Surg Clin North Am. 2002;82(1):221–35. https://doi.org/10.1016/S0039-6109(03)00151-8.CrossRefPubMed

White JM, Stannard A, Burkhardt GE, Eastridge BJ, Blackbourne LH, Rasmussen TE. The epidemiology of vascular injury in the wars in Iraq and Afghanistan. Ann Surg. 2011;253(6):1184–9. https://doi.org/10.1097/SLA.0b013e31820752e3.CrossRefPubMed

Heldenberg E, Givon A, Simon D, Bass A, Almogy G, Peleg K. Terror attacks increase the risk of vascular injuries. Front Public Health. 2014;2:47. https://doi.org/10.3389/fpubh.2014.00047.CrossRefPubMedPubMedCentral

Eastridge BJ, Mabry RL, Seguin P, et al. Death on the battlefield (2001–2011): implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012;73(6):S431–7. https://doi.org/10.1097/TA.0b013e3182755dcc.CrossRefPubMed

Fox N, Rajani RR, Bokhari F, et al. Evaluation and management of penetrating lower extremity arterial trauma: an eastern association for the surgery of trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5):S315–20. https://doi.org/10.1097/TA0b013e1827018e4.CrossRefPubMed

Jagdish K, Paiman M, Nawfar A, et al. The outcomes of salvage surgery for vascular injury in the extremities: a special consideration for delayed revascularization. Malays Orthop J. 2014;8(1):14–20. https://doi.org/10.5704/MOJ.1403.012.CrossRefPubMedPubMedCentral

10.

Lamont PM, Scott DJ. The impact of shortened training times on the discipline of vascular surgery in the United Kingdom. Am J Surg. 2005;190(2):269–72. https://doi.org/10.1016/j.amjsurg.2005.05.025.CrossRefPubMed

11.

Bruce PJ, Helmer SD, Osland JS, Ammar AD. Operative volume in the new era: a comparison of resident operative volume before and after implementation of 80-hour work week restrictions. J Surg Educ. 2010;67(6):412–6. https://doi.org/10.1016/j.surg.2010.05.007.CrossRefPubMed

12.

Burkhardt GE, Rasmussen TE, Propper BW, Lopez PL, Gifford SM, Clouse WD. A national survey of evolving management patterns for vascular injury. J Surg Educ. 2009;66(5):239–47. https://doi.org/10.1016/j.surg.2009.09.007.CrossRefPubMed

13.

Engelhardt M, Orend K‑H. Gefäß- und Thoraxverletzungen. Berlin, Boston: De Gruyter; 2021. pp. 79–140.

14.

Grabo DJ, DiMuzio PJ, Kairys JC, McIlhenny SE, Crawford AG, Yeo CJ. Have endovascular procedures negatively impacted general surgery training? Ann Surg. 2007;246(3):472–80. https://doi.org/10.1097/SLA.0b013e3181485652.CrossRefPubMedPubMedCentral

15.

Yan H, Maximus S, Koopmann M, et al. Vascular trauma operative experience is inadequate in general surgery programs. Ann Vasc Surg. 2016;33:94–7. https://doi.org/10.1016/j.avsg.2016.02.005.CrossRefPubMed

16.

Mackenzie CF, Tisherman SA, Shackelford S, Sevdalis N, Elster E, Bowyer MW. Efficacy of trauma surgey technical skills training courses. J Surg Educ. 2019;76(3):832–43. https://doi.org/10.1016/j.jsurg.2018.10.004.CrossRefPubMed

17.

Engelhardt M, Elias K, Friemert B, Klemm K, Willy C. Vascular surgical training concept for military surgeons in Germany. Unfallchirurg. 2018;121(7):544–9. https://doi.org/10.1007/s00113-018-0485-8.CrossRefPubMed

18.

Vascular International School. https://vascular-international.org.

19.

Duschek N, Assadian A, Lamont PM, et al. Simulator training on pulsatile vascular models significantly improves surgical skills and the quality of carotid patch plasty. J Vasc Surg. 2013;57(4):1148–54. https://doi.org/10.1016/j.jvs.2012.08.109.CrossRefPubMed

20.

Wilhelm M, Klemm K, Assadian A, et al. Improve your skills!: evaluation of a 2.5-day basic course in vascular surgery for surgical trainees. Chirurg. 2013;84(2):125–9. https://doi.org/10.1007/s00104-012-2395-6.CrossRefPubMed

21.

Wortmann M, Engelhardt M, Elias K, Popp E, Zerwes S, Hyhlik-Dürr A. Resuscitative endovascular balloon occlusion of the aorta (REBOA). Chirurg. 2020;91(11):934–42. https://doi.org/10.1007/s00104-020-01180-0.CrossRefPubMedPubMedCentral

22.

Tresson P, Touma J, Gaudric J, et al. Management of vascular trauma during the Paris terrorist attack of November 13th, 2105. Ann Vasc Surg. 2017;40:44–9. https://doi.org/10.1016/j.avsg.2016.09.011.CrossRefPubMed

Title: Training in vascular trauma surgery for non-vascular surgeons
Vascular trauma surgery skills course
Authors: M. Engelhardt
R. Schmid
B. Kölbel
A. Hyhlik-Dürr
S. Zerwes
C. Zischek
Publication date: 24-04-2023
Publisher: Springer Vienna
Keyword: Vascular Trauma
Published in: European Surgery / Issue 3-4/2023
Print ISSN: 1682-8631
Electronic ISSN: 1682-4016
DOI: https://doi.org/10.1007/s10353-023-00800-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Training in vascular trauma surgery for non-vascular surgeons

Vascular trauma surgery skills course

Summary

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Summary

Background

Methods

Results

Conclusion

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