Improving Fasciotomy Performance: A Focused Needs Assessment for Military Surgeon Simulation Training
Walter B Kucera, MD, Matthew D Nealeigh, DO, Brenton Franklin, MD, Mark Bowyer, MD, W. Brian Sweeney, MD, E. Matthew Ritter, MD. Uniformed Services University / Walter Reed National Military Medical CenterObjectives: Many injuries from the wars in Iraq and Afghanistan involve extremity trauma secondary to blasts. The wounding patterns from these blasts predispose patients to… Continue Reading
“HEAD TO HEAD” COMPARISON OF THREE STATE OF THE ART VIRTUAL REALITY ROBOTIC SURGERY SIMULATORS
Alexandria M Hertz, MD, Evalyn I George, BS, Christine M Vaccaro, DO, Timothy C Brand, MD. Madigan Army Medical CenterObjectives: Compare the face and content validity of the three most prevalent robotic simulators, and to include discussion regarding pricing and availability. Materials/Methods: 15 participants were asked to complete one task on three different robotic trainers,… Continue Reading
Bigger Is Not Better: Twenty-Year Institutional Experience of Atypical Ductal Hyperplasia Discovered by 11- and 8-Gauge Core Needle Biopsies
Jessica B Weiss, MD, Woo S Do, MD, Dominic M Forte, MD, Rowan R Sheldon, MD, Charles K Childers, Andrew D Mosier, DO, Vance Y Sohn, MD. Madigan Army Medical Center, Tacoma, WAObjectives: The increasing accuracy of large-bore (11- or 8-gauge) vacuum-assisted core needle biopsies (VACNB) has challenged the commonly-accepted practice that surgery is needed for… Continue Reading
Multimodal Pain Control in the Humanitarian Setting
Jonathan L Halbach, DO, Paul Lewis, DO, Jason Brill, MD, James Wallace, MD, Ashley Zander, DO, Mike VanGent, DO, Kyle Gadbois, MD. Naval Medical Center San DiegoObjective: The prescribing of narcotic pain medication during humanitarian medical missions presents an ethical dilemma with the potential for adverse events without reliable follow-up. Some countries prohibit the distribution… Continue Reading
IMPROVING COLORECTAL CANCER SCREENING WITHIN MILITARY FACILITIES BY UTILIZING STANDARDIZED QUALITY METRICS
Michelle Ganyo, MD, Lawson Robert, MD, Amanda Cimsit, MD. Naval Medical Center San DiegoINTRODUCTION: In 2015, the American Society of Gastrointestinal Endoscopy/American College of Gastroenterology Task Force on Quality in Endoscopy released updated guidelines on measuring quality in colonoscopy. This identified metrics and provided benchmark goals to serve as proxy measures for the quality of… Continue Reading
Mastery of General Surgery: An Impossible Task In The Army Healthcare System
Timothy P Plackett, DO, MPH1, Joel R Brockmeyer, MD2, Danielle B Holt, MD3, Robert M Rush, Jr, MD4, Joy Sarkar, MD5, Steven A Satterly, MD1, Jason M Seery, MD6, Bradley R Zagol, MD7. 1Womack Army Medical Center, 2Eisenhower Army Medical Center, 3Walter Reed National Military Medical Center, 4Madigan Army Medical Center, 5Brian Allgood Army Community… Continue Reading
Surgery at Sea: Are Military Surgery Training Programs Preparing New Graduates for Shipboard Surgery?
Matthew D Nealeigh, DO, Walter B Kucera, MD, Matthew J Bradley, MD, E. Matthew Ritter, MD, W. Brian Sweeney, MD, Elliot M Jessie, MD, Carlos J Rodriguez, DO. Uniformed Services University / Walter Reed National Military Medical CenterIntroduction: Recent decades brought revolutionary applications of technology to address surgical disease. Residency programs appropriately integrated advances into… Continue Reading
Impact of Number of Lymph Nodes in Lung Cancer Resection on Survival: A 10-Year Experience in a Department of Defense Institution to Include Quality of Lymph Node Sampling, Operative Procedure, Staging, and 5-year Survival
Bethany M Heidenreich, CPT, DO, Andrew S Durkee, CPT, DO, Julia O Bader, PhD, Vincent J Mase Jr., LTC, MD. William Beaumont Army Medical CenterObjectives: Assess a 10-year experience at our institution with regard to thoracic oncology, to include quality of regional lymph node (RLN) dissection as compared to the Commission on Cancer (CoC) surveillance… Continue Reading
Interim Analysis of a Prospective, Randomized Phase II Trial of Trastuzumab vs Trastuzumab + E75 for the Prevention of Recurrence in HER2 Overexpressing Breast Cancer Patients
Tommy A Brown, MD1, John W Myers, MD1, Kaitlin M Peace, MD1, Jennifer K Litton, MD2, Rashmi Murthy, MD3, Timothy J Vreeland, MD2, Diane F Hale, MD1, Garth S Herbert, MD1, Guy T Clifton, MD1, Mark O Hardin, MD4, George E Peoples, MD5, Elizabeth A Mittendorf, MD2. 1Department of Surgery, Brooke Army Medical Center, 2The… Continue Reading
TOO FAST, OR NOT FAST ENOUGH? THE FAST EXAM IN PATIENTS WITH NON-COMPRESSIBLE TORSO HEMORRHAGE
Woo S Do, MD1, Matthew J Eckert, MD1, Ronald Chang, MD2, Erin E Fox, PhD2, Charles E Wade, PhD2, John B Holcomb2, Matthew J Martin1. 1Legacy Emmanuel Medical Center, Portland, OR, 2Center for Translational Injury Research, University of Texas Health Science Center, Houston, TXObjectives: Trauma surgeons assessing patients with non-compressible torso hemorrhage (NCTH) often rely… Continue Reading
Mobile Forward Looking Infrared Technology Allows Rapid Assessment of Resuscitative Endovascular Balloon Occlusion of the Aorta in Hemorrhage and Blackout Conditions
Morgan R Barron, MD, John Kuckelman, DO, John McClellan, MD, Michael Derickson, MD, Cody Phillips, DO, Shannon Marko, DVM, Kyle Sokol, MD, Rowan Sheldon, MDMatthew Eckert, MD, Matthew Martin, MD. Madigan Army Medical CenterIntroduction: Objective assessment of final REBOA position and adequate distal occlusion is clinically limited, particularly in patients with hemorrhagic shock. We propose… Continue Reading
Delayed Presentations of Trauma Encountered during Large-Scale US Navy Humanitarian Aid Missions
Jason B Brill, LCDR, MC, USN, James D Wallace, LCDR, MC, USN, Romeo C Ignacio, CAPT, MC, USN. Naval Medical Center San DiegoObjectives: A 1000-bed floating hospital, USNS Mercy (T-AH 19) has provided large-scale humanitarian aid (HA) throughout Southeast Asia. As the focus of these missions, designated Pacific Partnership (PP), is to provide low risk,… Continue Reading
Saline Hydro-Flotation is Superior to Bioresorable Membranes in Decreasing Intra-Abdominal Adhesion Formation in a Rat Model
John Kuckelman, Morgan Barron, Kevin Kniery, Jeffrey Kay, Joseph Kononchik, Zachary Hoffer, Vance Sohn. Madigan Army Medical CenterINTRODUCTION: Adhesion formation after laparotomy remains a major cause of post-operative morbidity. Hyaluronate/carboxymethylcellulose membranes (HAC) are costly bioresorbable membranes that represent current anti-adhesion therapy. Alternatively, hydro-flotation using saline theoretically provides a transient barrier during adhesion formation. We sought… Continue Reading
Prolonged Field Care – The U.S. Air Force Pararescue Experience
Erik DeSoucy, DO1, Seth Zweben, NREMTP2, Stacy Shackelford, MD3, Joseph J DuBose, MD1, Russ S Kotwal, MD, MPH3, Harold R Montgomery, SOATP3, Sean Keenan, MD4, Stephen C Rush, MD2. 1David Grant Medical Center, 2U.S. Air Force Pararescue, 3Joint Trauma System, 4Special Operations Command, EuropeIntroduction: United States Air Force Pararescue is an elite special operations force… Continue Reading
Outcomes following administration of tranexamic acid in military traumatic brain injury
Patrick F Walker, MD, Joseph D Bozzay, MD, Luke R Johnston, MD, Eric A Elster, MD, Carlos J Rodriguez, DO, Matthew J Bradley, MD. Department of Surgery, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MarylandOBJECTIVES: Tranexamic acid (TXA) may be a useful adjunct for military patients with… Continue Reading