Trauma & Acute Care Surgery
The trauma surgery team is made up of general surgeons and fellowship-trained trauma surgeons who are specially trained to provide the highest level of trauma care, acute care surgery and surgical critical care. Patients seen by a Surgical Specialists of Colorado trauma surgeon are generally admitted through the Emergency Room of hospitals across the state or transported by helicopter to the Level 1 trauma center at St Anthony’s Hospital in Denver. Hospitals receive trauma designations based on the level of care they are able to provide for an acutely injured or ill patient. A level 1 trauma designation is the highest trauma designation and signifies the most advanced and comprehensive regional trauma center. The SSOC team of specialists is on-call at a number of hospitals across the state – from level 3 hospitals to level 1 trauma centers that receive patients with the highest acuity injuries.
Trauma surgeons are masters of good communication and enjoy the great continuity of care they are able to provide for patients. Trauma surgeons are always ready for something new or unexpected, they excel at rapid decision making and their surgical management of injury or illness often is credited with saving lives – something this team finds very gratifying and rewarding.
Because of the emergency nature of a trauma, their surgeries are a mix of open surgical procedures and minimally invasive, laparoscopic or robotic, procedures. When there is time and the patient is stable, they prefer to utilize minimally invasive techniques, but that is only possible in approximately 50% of the surgeries they perform. A trauma surgeon has three distinct roles within the hospital setting – trauma surgery, emergency general surgery – also known as acute care surgery, and surgical critical care.
Because trauma surgeons need to be ready for anything, they are dedicated to keeping up on the literature and newest advances in medicine, as their field is one of constant learning.
At the level 1 trauma center, St Anthony Hospital, Surgical Specialists of Colorado has one of their exceptionally trained trauma surgeons in the hospital at all times, so care is available 24 hours a day, 7 days a week. They also have backup coverage available and are trained to handle mass casualties, if the need arises. It is the goal of each surgeon on our team to provide the best care possible and help patients get home to their lives and their families as soon as possible
At each link below is further information on each of the roles of the trauma surgeon.
Trauma surgeons at SSOC are specially trained to provide immediate care for any type of traumatic injury an adult may experience. They see two types of trauma: blunt and penetrating.
Blunt trauma is often related to ski, snowboard and mountain bike injuries, car or motorcycle crashes, falls or injuries caused by being kicked by livestock or horses.
Penetrating trauma are injuries that are caused by an external force and would be characterized as any injury where a foreign object enters the body. Stab wounds and gunshot wounds would fit into this category of trauma.
The primary goal for a trauma surgeon is to stop any hemorrhage or blood loss to save lives. They work to stop bleeding in the chest or the abdomen and they also coordinate care between other medical specialties - orthopedic surgery, neurosurgery, urology, plastic surgery or vascular surgery to care for patients with traumatic injuries. Along with coordinating specialty care, trauma surgeons are responsible for the overall management of the patient - from the operating room to the intensive care unit. These doctors care for the overall needs of each individual patient. Common surgeries that a trauma surgeon would perform include:
- Splenectomy – the removal of the spleen if it is lacerated, ruptured or hemorrhaging
- Vascular repairs anywhere in the body
- Exploratory surgery of the abdomen and chest to look for and stop bleeding
- Bleeding in the chest or any structure in the abdomen
- Bowel resections and intestinal repairs
- Liver injuries
Resuscitation is performed blood and blood products to achieve stability in anyone who is hemorrhaging (bleeding) and unstable.
Surgical Specialists of Colorado has surgeons in the Denver area that cover the most serious and life-threatening cases from around the state and the region at St Anthony’s Hospital, in Lakewood. They have access to a special room, called the T10 room, that does not exist in many places. This room is a quick elevator ride away from the helicopter that transports patients to the hospital from around the region. This room is large and contains every piece of equipment that would be needed in an emergency. It can accommodate an entire multi-disciplinary team of doctors including trauma surgeons, anesthesiologists, interventional radiologists, orthopedic surgeons, neurosurgeons, urologists, plastic surgeons or any other specialist needed. Here the entire team can come together and work side-by-side in cases where time is of the essence and a patient needs emergency surgery or resuscitation.
Acute care surgery is also known as emergency general surgery and it encompasses any emergent or unplanned procedure that may be necessary. The surgeon prioritizes a timely diagnosis as these patients almost exclusively come to the hospital through the ER, with an injury or illness that is causing a significant problem or pain that needs to be treated immediately. Therefore, the surgeries that are performed in an acute care setting are unplanned and not elective surgeries.
Common emergency general surgeries include:
- Appendectomy – the removal of the appendix
- Cholecystectomy – surgery for the inflammation or infection of the gall bladder
- Bowel obstructions
- Ischemic bowel – treating low blood flow or a lack of blood flow to the intestines
- A variety of intestinal emergencies - Bleeding, obstructions, infections and perforations of the intestines, removal of masses, perforated ulcers, or any gastrointestinal emergency
- Hernia repairs
- Previously undiagnosed cancer
- Skin and soft tissue infections - abscesses, necrotizing fasciitis
In an emergency, some of these surgeries may need to be open surgeries, however, many of these surgeries are completed in a minimally invasive fashion either laparoscopically or robotically. If a patient is stable, a gallbladder surgery or a hernia surgery are almost always performed as minimally invasive procedures.
Surgical critical care is the management of surgical and trauma patients in the Intensive Care Unit.
Surgical Specialists of Colorado has a number of board-certified critical care intensivists. They manage the sickest patients in the hospital and are experts in stabilizing their vitals and managing the most complicated medical conditions. These doctors visit their patients many times a day and enjoy forming relationships with their patients and their families. Because they are providing the management of all their medical issues – the intensivists also utilize a multi-disciplinary team to care for the patient. They coordinate with the pharmacy, nutrition experts, social workers, case managers, nursing and other medical specialties, as needed.
Everything they do revolves around one central goal, which is to stabilize a critically ill or injured patient and help them recover so that they can get home as soon as possible.
In the course of their day, these doctors treat various forms of shock and are also well-versed in bedside procedures such as:
- Central lines - needed for certain types of medications for hemodynamic/blood pressure, monitoring or resuscitation
- Hemodialysis catheters - for patients in renal (kidney) failure to provide renal replacement therapy
- Chest tubes - to drain bleeding in the chest or air around the lungs
- Dressing changes for wound care
- Intubations - for individuals who are in respiratory failure or on life support
- Tracheostomy tubes - a tube placed in the neck for long-term respiratory failure
- Feeding tubes – for individuals who cannot eat on their own. These are generally placed in the operating room or as a bedside procedure.
- Arterial lines - for beat to beat monitoring of blood pressure, which is a more accurate way to monitor blood pressure especially in patients who have extremely low blood pressure.