Trauma Surgery

Trauma surgery is a specialty in surgery that focuses on the treatment and care of often life-threatening wounds caused by impact factors.  Impact forces can be caused by a variety of situations, but some of the more frequent ones are falls, sports, crush injuries, and gunshot or stabbing injuries. 

Trauma surgeons frequently work with a broader group of specialized surgeons in major trauma situations, including orthopedic, vascular, maxillofacial, cardiothoracic, plastic, and neurosurgeons. Fast-paced and challenging, trauma surgery leaves little opportunity for in-depth conversations that are common in some medical consultations. 

A basic medical degree is typically followed by training to become a trauma surgeon. This training can take 10 years or longer in most nations along with a medical degree. Also, in some jurisdictions, trauma surgeons may perform the responsibilities that general surgeons would perform. Acute surgical care is what is used to describe this specialty when it is paired with emergency general surgery. (1)

Definition and Overview

Trauma surgery is a discipline of surgical medicine that manages injuries caused by impact. For instance, a trauma surgeon might be requested to assess a patient who has just been in a vehicle accident at the emergency room.

Experiencing a blunt force or penetrating trauma can result in injuries, which are referred to as trauma. Trauma can be defined as "major trauma." Many trauma patients are victims of automobile accidents, stabbings, and gunshot wounds. Trauma can also result from accidents involving pedestrians, falls, and crush injuries.

Internal organs, bones, the brain, and other soft parts of the body are all susceptible to traumatic damage. Trauma can range from slight to significant, and it can affect any part of the body. (2)

Procedures

Trauma surgeons are experts at identifying and surgically correcting trauma brought on by illnesses and traumas. They ought to evaluate a person's condition as soon as possible and decide what kind of surgery, if any, is required. The emergency room of a hospital is typically where a trauma surgeon works. Conditions that a trauma surgeon may treat include:

• Blunt or Penetrating Trauma

Blunt trauma refers to any injury brought on by a powerful impact. Accidents involving motor vehicles falls, or attacks are frequent causes. Penetrating trauma, which includes gunshot wounds, stab wounds, and injuries from farm equipment, is an injury caused by an item that punctures the skin and adjacent tissues.

• Acute Care & Emergency General Surgery Conditions

People occasionally suffer unanticipated medical emergencies that call for prompt surgical treatment. Appendicitis, diverticulitis, cholecystitis, perforated bowel, perforated ulcers, abdominal abscesses, incarcerated hernias, and intestinal blockages are all conditions that trauma surgeons can treat.

• Burns

To treat severe burns such as thermal burns, chemical burns, frostbite, and inhalation burns, patients may need a trauma surgeon. Emergency surgery, skin excision, and skin grafting techniques are all possible options for treatment. 

• Surgical Critical Care Conditions

On patients who are already in the hospital for another surgery or procedure, trauma surgeons also carry out surgical critical care procedures. People who have sepsis, respiratory failure, multiple organ failure, or coagulopathy are included in this.

A trauma surgeon will quickly assess the patient's medical condition and decide on the best course of treatment if they present to the emergency room with any of these life-threatening injuries or conditions. It means that sometimes getting patients into emergency surgery is necessary.

The procedures a trauma surgeon uses depend on the patient's situation. These procedures may also include:

• Resuscitation
• Chest wall stabilization
• Exploratory laparotomy
• Emergency thoracotomy

Following emergency care, a trauma surgeon will either continue to provide care for the patient while they are recovering or hand over responsibility for care to another doctor or surgeon.  (3)

Candidates

The specific surgical treatment and procedures performed vary depending on the patient, the nature and severity of the trauma. Patients treated by trauma surgeons have traumas caused by:

• car and motorcycle accidents
• farm and factory accidents
• animal attacks
• fall
• gunshot wounds
• stab wounds
• burns (4)

Risks and Side Effects

Like every procedure, trauma surgery has some risks and possible complications. Depending on the kind and extent of the injury, the surgical approach employed, and specific patient characteristics, various risks may arise. Here are a few typical risks that can develop following trauma surgery:

• mortality,
• thromboembolic events, 
• infections, 
• stroke, 
• organ failure, 
• need for intensive care unit (ICU) stays,
• and sepsis.

The patient's death is the most serious complication that could happen. As the damage gets worse and the facility can't handle the type of emergency or the patient is stabilized, the likelihood of this happening rises.

Amputation of limbs, visceral damage, neurological abnormalities, and loss of function are just a few of the long-term issues that can arise from delaying trauma surgery when it is required. Fortunately, improvements in science and engineering over the past few decades have made it possible to comprehend the processes that lead to morbidity and mortality in major injuries. (5,6)

Post-Procedure and Follow-up

The emergency doctor will see the patient, stabilize the situation, and assess and conduct tests and imaging studies when the patient visits the emergency room with any problem. The doctor will notify the necessary specialists, including the trauma surgeon. The role of the emergency department doctor includes making referrals for admission or discharge along with the proper care and referrals for follow-up care.

The patient is given to the trauma surgeon, who will continue treatment if the circumstance necessitates trauma surgery. The trauma surgeon will oversee the patient's healing, rehabilitation, and discharge processes in addition to performing the surgery. 

The healthcare team will typically schedule routine follow-up appointments to assess wound healing, track the recovery process, handle any complications, and modify the treatment plan as necessary.

Recovery

For better recovery, it could be necessary to undergo physical therapy and rehabilitation to regain strength, mobility, and function. To meet the unique needs of the patient, this may entail exercises, stretches, gait training, and other methods.

The process of recovering from trauma surgery is gradual and varies depending on the patient. According to their surgeon's advice, patients are frequently instructed to gradually raise their activity level and resume their regular daily activities. To guarantee safe and effective recuperation, it's critical to adhere to the advice given by healthcare providers. 

Results

For better results, it can be advantageous to have strong support which involves family, friends, or therapy to provide emotional support during the recovery process.

It is crucial to keep in mind that several variables, such as the severity of the trauma, the patient's overall health, age, and the existence of any existing illnesses, might influence the healing process. The course of each person's recovery is different, and medical professionals will offer tailored advice depending on their particular situation.