Article ID: 15-1
We looked back on the 10 years of acute care surgery 〈ACS) at our department and discussed what type of ACS is required in facilities in regional cities. In our department, the emergency and critical care unit started in 2012, which required major changes in the surgical emergency treatment system. At the regional level, we focused on maintaining the existing emergency system, and we established a system in which severe injuries and trauma cases were concentrated in our department. At the facility level, ACS team was formed with existing surgeons to facilitate trauma care and actively intervene in trauma care. In addition, to maintain the team, we improved the on-call system and implemented complete division of labor in perioperative management. At the individual level, we performed daily surgical tasks with a specialty to maintain surgical skills and motivation. In addition, we made efforts to encourage young surgeons and residents to intervene in the practice in order to foster the Acute care surgeons. In this way, we believe that ACS in regional cities can be established by maintaining the existing emergency system and having existing surgeons create a system that is suited to the facilities.