Abstract
The decline in trauma surgery and decrease in young surgeons have become problems in Japan, as in the USA. In our emergency center, acute care surgeons undertake emergency room practice, emergency surgery, and intensive care for critically ill abdominal emergency surgical patients. In the past ten years in our center, there were 570 abdominal trauma patients (blunt injury 476, penetrating injury 94) and 673 non trauma disease patients (perforating peritonitis, intestinal ischemia, ileus, rupture of abdominal aortic aneurysm, etc.), not including cardiopulmonary arrest and acute appendicitis patients. The hospital mortality rate of the 58 patients with failure of more than four organs was 48%, which is superior to the outcomes in Europe and the USA. For the past five years, 30 complicated emergency surgical patients were transferred to our center, of whom 7 died. Most patients have been seen by a surgeon, and problems included an inadequate primary survey and treatment plan, delayed diagnosis, and a lack of intensive care. An acute care surgeon acting as an emergency physician improves the survival rate of critically ill emergency surgical patients and plays an important role in the education of surgeons and emergency physicians. Therefore, the nurturing of acute care surgeons is very important.
