[Vascular surgical training concept for military surgeons in Germany]

Unfallchirurg. 2018 Jul;121(7):544-549. doi: 10.1007/s00113-018-0485-8.
[Article in German]


Background: Due to the increasing threat of terrorist attacks and assassinations even in Europe, the interest in management of severe vascular injuries, which, with an increased incidence of 10% are to be expected with such penetrating wounds, is also growing; however, with increasing subspecialization in surgery there is a threat that the know-how in vascular surgery will become lost among non-vascular surgical specialists. Therefore, the Germany military established an educational program, the so-called DUOplus concept, to ensure that future military surgeons acquire and retain the experience and skills to fulfill the demanding role of a deployed surgeon.

Objective: The DUOplus concept of the German Medical Forces is introduced with a special focus on vascular surgery training.

Results: All trainee German military surgeons attain a second specialization alongside general surgery. This residency includes several courses in various surgical specialties as well as a 12-month rotation in a vascular surgery department. The core elements of vascular trauma training are two practical courses on life-like models. In these courses, which were developed especially for the needs of non-vascular surgeons in hands-on training, open surgical techniques and damage control measures including resuscitative endovascular balloon occlusion of the aorta (REBOA) are taught on suitable models and intensively practiced.

Conclusion: All surgeons potentially confronted with traumatic and iatrogenic vascular injuries should have some basic competence in the management of vascular trauma. Especially the courses in vascular surgery for non-vascular surgeons offer such a skill set for every surgeon. Next to the German military surgeons, the courses are attended more and more by civilian and military surgeons from different surgical specialties and nationalities.

Keywords: Armed conflicts; Exsanguination; Mass casualty incidents; Terrorist attacks; Vascular trauma.

MeSH terms

  • Clinical Competence
  • Europe
  • Germany
  • Humans
  • Military Medicine* / education
  • Military Personnel*
  • Surgeons*
  • Vascular Surgical Procedures* / education