The impact of patient volume on surgical trauma training in a Scandinavian trauma centre

Objective: Some of the problems faced in trauma surgery are increasing non-operative management of abdominal injuries, decreasing work hours and increasing sub-specialisation. We wanted to document the experience of trauma team leaders at the largest trauma centre in Norway, hypothesising that the patient volume would be inadequate to secure optimal. trauma care. Methods: Patients registered in the hospital based Trauma Registry during the 2-year period from 1 August 2000 to 31 July 2002 were included. Results: Of a total of 1667 patients registered, 645 patients (39%) had an Injury Severity Score (ISS) > 15. Abdominal injuries were diagnosed in 205 patients with a median ISS of 30. An average trauma team leader assessed a total of 119 trauma cases a year (46 patients with ISS > 15) and participated in 10 trauma laparotomies. Conclusion: Although the total number of trauma cases seems adequate, the experience of the trauma team leaders with challenging abdominal injuries is limited. With increasing sub-speciatisation and general surgery vanishing, fewer surgical specialities provide operative competence in dealing with complicated torso trauma. A system of additional education and quality assurance measures is a prerequisite of high quality, and has consequently been introduced in our institution. (c) 2005 Elsevier Ltd. All rights reserved.