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The Role of SVS Volunteer Vascular Surgeons in the Care of Combat Casualties: Preliminary Results from Landstuhl, Germany

Ruth L. Bush¹, Ronald M. Fairman², Stephen F. Flaherty³, David L. Gillespie.⁴

¹Scott & White Hospital, Texas A & M University Health Sciences Center, Temple, Texas;²University of Pennsylvania, Philadelphia, Pa.;³Landstuhl Regional Medical Center, Landstuhl, Germany;⁴Walter Reed Army Medical Center, Washington, D.C.

OBJECTIVES: With a shortage of active duty vascular surgeons in the military, SVS members have been called upon to perform short-term rotations at Landstuhl Regional Medical Center (LRMC), the U.S. military's receiving facility for combat injuries sustained in the Iraq and Afghanistan conflicts. We report the preliminary results of a volunteerism model utilizing civilian vascular surgeons in the care of wounded soldiers.

METHODS: Since September 2007, SVS vascular surgeons have performed 2 week rotations at LRMC through American Red Cross and U.S. Army sponsorship. Volunteers were surveyed for previous military and/or trauma experience. In addition to reporting number and types of procedures performed, volunteers were queried on their experience and impression of the rotation.

RESULTS: To date, 8 SVS volunteer surgeons have rotated at LRMC. None had prior military experience but all had vascular trauma experience through residency, fellowship and current practices. With most definitive vascular repairs being done in theater, SVS members were most often called upon for clinical expertise in the care of combat casualties. The volunteers participated in a variety of cases with the most common being wound examinations under anesthesia for which intraoperative vascular consultation was requested (8-20 per volunteer). Additional cumulative procedures were as follows: IVC filter placement (n=25), thrombectomy and revision of lower and upper extremity interposition vein grafts (n=5), retroperitoneal spine exposures (n=4), diagnostic and therapeutic (vascular embolization) carotid angiograms (n=2), iliac stent (n=1), and Duplex ultrasound interrogation of vascular repairs, suspected arterial injuries and deep vein thrombosis. All volunteers described the experience as valuable and will return if needed.

CONCLUSIONS: With a limited number of military vascular surgeons and the unpredictable need for a specialist at LRMC, civilian volunteers are playing an important role in providing high quality vascular care for the nation’s wounded soldiers by expanding vascular and endovascular capability at LRMC. As volunteers, SVS members are carrying on a tradition started by our surgical forefathers during previous U.S. military conflicts.
*Data from 12 additional volunteers will be available by June 2008

AUTHOR DISCLOSURES: R.L. Bush, None; R.M. Fairman, None; S.F. Flaherty, None; D.L. Gillespie, None.