• M Margaret Knudson, Thomas W Evans, Raymond Fang, Kathleen D Martin, Warren Dorlac, David L Gillespie, Kenneth J Cherry, Todd E Rasmussen, and Military Liaison Committee of the American Association for the Surgery of Trauma, the Society for Vascular Surgery, and the American College of Surgeons’ Committee on Trauma.
• From the University of California (M.M.K.), San Francisco, California; Institute of Surgical Research (T.W.E.), Fort Sam Houston, Texas; US Air Force C-Stars (R.F.), Baltimore; and US Combat Casualty Care Research Program (T.E.R.), Fort Detrick, Maryland; Landstuhl Regional Trauma Center (KM), Landstuhl, Germany; University of Cincinnati (W.D.), Cincinnati, Ohio; Heart and Vascular Center (D.L.G.), New Beford, Massachusetts; University of Virginia (K.L.C.), Charlottesville, Virginia.
• J Trauma Acute Care Surg. 2014 Mar 1;76(3):878-83; discussion 883.

BackgroundThe Senior Visiting Surgeon (SVS) program at Landstuhl Regional Medical Center (LRMC), Germany, was developed during the wars in Afghanistan and Iraq as a measure to build military-civilian interaction in trauma care and research. The objective of this study was to provide a summary of the program including workload and experiences. An additional objective was to identify factors needed for sustainment of this program during an interwar period.MethodsAn electronic, 34-question survey was distributed to 192 surgeons who participated in the SVS program at LRMC, either through the American Association for the Surgery of Trauma or the Society of Vascular Surgery between 2005 and 2012. The survey was composed of multiple-choice and open-ended questions.ResultsThe response rate was 61% (n = 118), with 24% (n = 28) indicating previous military service. These 117 respondents provided 24.5 months of volunteer coverage at LRMC, with 22% (n = 26) performing multiple, 2-week rotations. Visiting surgeons participated in two to five operative cases per week, with the majority of operations related to the management of soft tissue wounds and burns followed by abdominal and vascular procedures, conducted daily multidisciplinary intensive care unit rounds, and collaborated with military surgeons in research projects resulting in 22 publications. More than half (n = 59) of the respondents maintained contact with military colleagues during the 12 months following the rotation. The majority of surveyed surgeons support continuation of the SVS at military facilities in the United States and hosting military surgeons at their civilian trauma center.ConclusionThis study is the first to quantify the SVS program during the wars in Afghanistan and Iraq. Visiting surgeons provided more than 2 years of combat casualty care during these, the longest wars in US history. Continuation of this program will require expanded military-civilian interaction in trauma care, training, and research during any interwar period.

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