BMJ  2006;332:805-806 (8 April), doi:10.1136/bmj.332.7545.805

Editorial

The neglect of trauma surgery

To improve outcomes, general trauma surgeons need training and recognition

The first 150 words of the full text of this article appear below.

Many otherwise capable surgeons are challenged by seriously injured patients. Surgeons responding to the London bombings of 7 July 2005 had to contend with many cases of blast trauma and associated injury, but only a handful had experience of similar casualties. The management of severely injured patients is demanding because trauma does not respect the boundaries of anatomy or the surgical specialty.1 Yet the UK lacks both training opportunities for trauma surgery and a service infrastructure, problems that other countries have recognised and started to remedy.

The presence of a general surgeon in the multidisciplinary trauma team remains important: death from occult cavity haemorrhage is ranked second only to major head injury as a cause of death after trauma and is often preventable.2 Techniques such as resuscitative thoracotomy, damage control laparotomy, and rapid control of vascular injury are life saving, yet general surgeons working in the UK have few . . . [Full text of this article]

Nigel R M Tai, specialist registrar in vascular surgery

Royal Free Hospital, London

James M Ryan

Leonard Cheshire professor of emergency medicine, University College Hospital, London
(james.ryan@ucl.ac.uk)

Adam J Brooks, consultant surgeon

Queen's Medical Centre, Nottingham


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