Innovation in surgical trauma care education: assessment of a Panamerican Trauma Society online surgical skills course hosted by the Spanish Surgical Association.

PURPOSE: Incorporating surgical skills education in trauma care is essential for young surgeons and surgical trainees. This study describes an innovative e-learning course for teaching trauma care surgical skills in an international cooperative setting. Furthermore, it aims to offer valuable insights on enhancing e-learning practices. METHODS: The Panamerican Trauma Society and the Spanish Surgical Association have joined forces to launch an online course focusing on advanced trauma care surgical skills. This report provides an in-depth examination of the project and scrutinizes participant feedback through a post-course survey. The survey thoroughly evaluates their satisfaction level, the usefulness of the course content, and their view on its clinical relevance. RESULTS: Three hundred eighty-two surgeons from 16 countries completed an online course. Three hundred seventy-nine of them responded to the post-course survey. The mean age was 36, with 64% females and 36% males. The course consisted of 9.9 h of academic content, including 5 h of video lectures and 4.9 h of live discussions. Ninety-seven percent of the participants were practicing general and acute care surgeons, and only 2% were exclusively dedicated to trauma surgery. Sixty-one percent of participants highly valued real-time interaction with faculty, and 95% believed their trauma surgical skills would improve. Additionally, 93% of the participants were satisfied or very satisfied with the e-learning experience. CONCLUSIONS: The use of video-based instructional materials has revolutionized surgical education. With online courses in trauma surgery, surgeons can now improve their skills and better prepare themselves to handle severe trauma cases. This innovative approach to surgical education has proven to be very effective and can potentially enhance patients' quality of care.

Different Crises, Different Patterns of Trauma. The Impact of a Social Crisis and the COVID-19 Health Pandemic on a High Violence Area.

BACKGOUND: Santiago, Chile underwent two separate periods of crisis over the past year. The first period, the 'social crisis,' extended over thirteen weeks in late 2019 into early 2020 due to protests over income inequality and the government response to social unrest. The second period, the 'health crisis,' began in March 2020 with Chile's first case of COVID-19 and escalated rapidly to include 'stay at home orders,' traffic restrictions, and the shuttering of most businesses. We wished to evaluate the impact of these crisis periods on trauma epidemiology. METHODS: We performed a retrospective review of the South-East Metropolitan Health Service Trauma Registry. Trauma admissions, operative volume, and in-hospital mortality were evaluated during the crisis period and the year prior. RESULTS: The social crisis saw increased levels of trauma, both blunt and penetrating, relative to the time period immediately preceding. The health crisis saw an increase in penetrating trauma with a concomitant decline in blunt trauma. Both crisis periods had decreased levels of trauma, overall, compared to the year prior. There were no statistically significant differences in in-hospital trauma mortality. CONCLUSION: Different crises may have different patterns of trauma. Crisis periods that include extended periods of lockdown and curfew may lead to increasing penetrating trauma volume. Governments and health officials should anticipate the aggregate impact of these measures on public health and develop strategies to actively mitigate them. LEVEL OF EVIDENCE: III.

Clampeamiento hepático prolongado: una alternativa en el trauma hepático severo / Clampeamiento prolonged liver: an alternative in severe hepatic trauma

Exponer la experiencia en el manejo del trauma hepático con clampeamiento prolongado, en el Servicio de Cirugía Uno. Hospital General del Este "Dr. Domingo Luciani". Paciente masculino de 28 años que ingresa a la Unidad de Politraumatizados (UPT) posterior a accidente en motocicleta. Hemodinámicamente estable, examen físico, tórax: murmullo vesicular disminuido en base derecha y abdomen; signos de irritación peritoneal, Rx de tórax hemoneumotórax y fractura del tercero al séptimo arcos costales derechos; toracotomía mínima que drena abundante burbujeo y 500 cc serohemático, FAST: moderada cantidad de líquido libre. Se realiza laparotomía exploradora con hallazgos de: hemoperitoneo 3000cc y lesión hepática grado IV; se realiza primera fase de control de daños, con clampeamiento y empaquetamiento hepático como estrategia para el control de la hemorragia; y cierre abreviado. Segunda fase de control de daños en la Unidad de Terapia Intensiva (UTI) durante 48 horas, posterior a lo cual, se realiza tercera fase de control de daños, con hallazgos de ausencia de hemoperitoneo, 100cc de secreción biliar, lesión en segmento VIII hepático no sangrante. Se retiran comprensas y clamps hemostático lavado, drenaje de cavidad y cierre con puntos de tensión. Evoluciona satisfactoriamente, egresando de la UTI, complicado con fístula biliar resuelta con papilotomía electiva en el postoperatorio tardio.