What does it mean to be a Trauma Center? 1989-2009: Results of the last year and review of 20 years experience in managing trauma patients

Abstract

It has been two decades since Maggiore Hospital Trauma Center started its formal activity focused on improving and developing Trauma management and Surgery of Trauma. Whilst evaluating the results of the last year, we can not avoid to look behind at the beginning, comparing the actual activity with the settings we have started from, in 1989. Before this date in our hospital all the Emergency and Trauma Surgery was managed by General Surgeons. However since 1989 few surgeons and ICU anaesthetists started to focus their training and activity on management of Trauma. From there has born the first organized, structured Level I Trauma Center holding all diagnostic and therapeutic resoureces and recognized by the Health Management Plan of the Emilia – Romagna Region Authority, within a region including almost two millions inhabitants.

The Trauma Surgery team adopted the evolving concept of Damage Control Surgery, applying extensively the intraabdominal packing and improving the perihepatic packing with a relevant refinement in the operative technique.

Furthermore Non Operative Management has extensively spread. All the above cited improvements, particularly the extensive use of NOM and the reduction of operative times, following the DCS philosophy and techniques, contributed to decrease morbidity and mortality rates of the abdominal trauma surgery patients. Mortality has been brought significantly down to 2.4%, in all cases related to extra-abdominal reasons. Last but least needs to be mentioned our scientific and research activity, including several published articles and scientific presentations at Italian, European and International Conferences. Finally we organize since 8 years a nationally relevant educational event: the “Corso TeoricoPratico di Chirurgia del Politrauma”. It is a theoretic and practical Trauma Surgery Course for Consultant/Attending Surgeons and Senior Registrars/Residents who want to improve their skills in Trauma Surgery and Management. and is now running its XIX edition.