Establishment of a combat damage control surgery training platform for explosive combined thoraco-abdominal injuries

Wen-Qiong Du; Ren-Qing Jiang; Zhao-Wen Zong; Lin Zhang; Zhao Ye; Xin Zhong; Yi-Jun Jia

Chinese Journal of Traumatology (Jul 2022)

Establishment of a combat damage control surgery training platform for explosive combined thoraco-abdominal injuries

Wen-Qiong Du,
Ren-Qing Jiang,
Zhao-Wen Zong,
Lin Zhang,
Zhao Ye,
Xin Zhong,
Yi-Jun Jia

Affiliations

Wen-Qiong Du: State Key Laboratory of Trauma, Burn and Combined Injury, Department for Combat Casualty Care Training, Training Base for Army Health Care, Army Medical University, Chongqing, 400038, China
Ren-Qing Jiang: Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400038, China
Zhao-Wen Zong: State Key Laboratory of Trauma, Burn and Combined Injury, Department for Combat Casualty Care Training, Training Base for Army Health Care, Army Medical University, Chongqing, 400038, China; Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400038, China; Corresponding author. State Key Laboratory of Trauma, Burn and Combined Injury, Department for Combat Casualty Care Training, Training Base for Army Health Care, Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing City, China.
Lin Zhang: State Key Laboratory of Trauma, Burn and Combined Injury, Department for Combat Casualty Care Training, Training Base for Army Health Care, Army Medical University, Chongqing, 400038, China
Zhao Ye: Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400038, China
Xin Zhong: State Key Laboratory of Trauma, Burn and Combined Injury, Department for Combat Casualty Care Training, Training Base for Army Health Care, Army Medical University, Chongqing, 400038, China
Yi-Jun Jia: State Key Laboratory of Trauma, Burn and Combined Injury, Department for Combat Casualty Care Training, Training Base for Army Health Care, Army Medical University, Chongqing, 400038, China

Journal volume & issue: Vol. 25, no. 4
pp. 193 – 200

Abstract

Read online

Purpose: It is challenging to prepare military surgeons with the skills of combat damage control surgery (CDCS). The current study aimed to establish a damage control surgery (DCS) training platform for explosive combined thoraco-abdominal injuries. Methods: The training platform established in this study consisted of 3 main components: (1) A 50 m × 50 m square yard was constructed as the explosion site. Safety was assessed through cameras. (2) Sixteen pigs were injured by an explosion of trinitrotoluene attached with steel balls and were randomly divided into the DCS group (accepted DCS) and the control group (have not accepted DCS). The mortality rate was observed. (3) The literature was reviewed to identify the key factors for assessing CDCS, and testing standards for CDCS were then established. Expert questionnaires were employed to evaluate the scientificity and feasibility of the testing standards. Then, a 5-day training course with incorporated tests was used to test the efficacy of the established platform. In total, 30 teams attended the first training course. The scores that the trainees received before and after the training were compared. SPSS 11.0 was employed to analyze the results. Results: The high-speed video playback confirmed the safety of the explosion site as no explosion fragments projected beyond the wall. No pig died within 24 h when DCS was performed, while 7 pigs died in the control group. After a literature review, assessment criteria for CDCS were established that had a total score of 100 points and had 4 major parts: leadership and team cooperation, resuscitation, surgical procedure, and final outcome. Expert questionnaire results showed that the scientific score was 8.6 ± 1.25, and the feasibility score was 8.74 ± 1.19. When compared with the basic level, the trainees’ score improved significantly after training. Conclusion: The platform established in this study was useful for CDCS training.

Published in Chinese Journal of Traumatology

ISSN: 1008-1275 (Print)
Publisher: Elsevier
Country of publisher: China
LCC subjects: Medicine: Medicine (General)
Website: https://www.journals.elsevier.com/chinese-journal-of-traumatology/

About the journal

Abstract

Keywords