Trauma surgery is the specialization in surgery that focuses on the treatment and care of injuries, often life-threatening, that are caused by impact forces. The causes of impact forces are many, but some of the more common ones include traffic accidents, falls, sports and crush injuries, as well as gunshot or stabbing wounds.
In catastrophic incidents, trauma surgeons often form part of a larger team of specialized surgeons such as orthopedic (i.e. specialist for musculoskeletal injuries), vascular (i.e. specialist for the arteries, veins and other vessels), maxillofacial (i.e. specialist for facial injuries), cardiothoracic (i.e. specialist for the heart and thoracic organs), plastic (i.e. special for the reconstruction of body areas following) and neurosurgeons (i.e. specialists for injuries to the brain and nervous system).
Trauma surgery is a fast-paced and demanding practice that has very little time for the lengthy discussions that may otherwise be seen in some medical consultations. The trauma surgeon generally undergoes training after completion of a basic medical degree.
This training together with the medical degree may take up to a decade or more in most countries. Moreover, in some jurisdictions, trauma surgeons may also conduct the duties that would otherwise be done by general surgeons. This discipline, when combined with urgent general surgery may be referred to as acute surgery care.
Procedures involved in trauma surgery
In most jurisdictions, trauma surgeons are adequately trained and equipped to identify and handle injuries to the head and neck, abdominal area, chest, legs, feet, arms and hands. Any patient that has experienced traumatic physical injury may be seen by a trauma specialist.
Upon arrival to the emergency room, patients are quickly assessed to identify the extent of the injuries and which are the most threatening to function and life. Resuscitation and stabilization are key priorities prior to surgical operations if urgent surgery is not necessary to save the patient’s life. This is then followed by definitive surgical therapy.
Methods used to assess the extent of injury include radiographic X-rays and CT-scans as well as MRI’s. With these tools the surgeon is able to identify damage to internal organs and hemorrhaging. Trauma surgeons work closely with emergency staff in the resuscitative and stabilization efforts of the patient.
Airway patency, breathing, circulation and necessary drugs are the key parameters controlled. Triage care at admission checks typical details, such as the patient’s vital signs, age and history or pre-existing conditions, like cardiopulmonary diseases. Laboratory tests, like blood tests, may be necessary, as well as intravenous access lines and equipment for monitoring vital signs.
The most serious complication that may arise is the death of the patient. The probability of this increases with increasing severity of the injury and the facility’s inability to handle the type of emergency and/ or stabilize the patient.
Failure to provide trauma surgery immediately in cases where it is required may lead to a wide range of long-term problems, which include, but are not limited to, limb amputation, internal organ damage, neurological deficits and loss of function. Fortunately, advances in medicine and technology over the past few decades have allowed for the improvement of understanding the events that cause morbidity and mortality in severe injuries.
Reviewed by Liji Thomas, MD