Acute Care Surgery Rotation
An Acute Care Surgery rotation and service has recently been created within the Department of General Surgery. This rotation encompasses the disciplines of Trauma Surgery, Surgical Critical Care, Burn Surgery, and Emergency General Surgery.
Trauma Surgery – Wake Forest Baptist Medical Center is one of five Level I Trauma Centers in the state of North Carolina and is verified by the American College of Surgeons as a Level I Adult Trauma Center. Between 2800-3000 trauma and burn patients (85% blunt/ 15% penetrating) are admitted to the trauma service each year from a large catchment area of Western North Carolina, Southern Virginia and Eastern Tennessee. This large population base allows for an unusual combination of a very busy trauma center in a city of a manageable size.
All of the attendings are trained in both trauma and critical care and have a genuine interest in teaching. Within a defined framework, there is a great deal of graduated autonomy for residents on the service, with much of the day-to-day decision making beginning at the resident level. The service is composed of two 4th year residents, one 3rd year resident, 2-3 interns, and 4 Trauma Nurse Practitioners. The operative experience for residents is comprehensive, as the trauma attendings provide supervision in the operative care of intra-abdominal pathology, vascular injury and repair, operative techniques in acute thoracic injury, soft tissue injury and burn care. We believe the service provides the residents with a broad based experience of the care of the injured patient with autonomy as is appropriate for each level.
Surgical Critical Care - Members of the Surgical Critical Care rotation oversee the care of all general surgical and trauma patients admitted to the intensive care unit. The service is composed of 2 PGY-2 residents, 2 Critical Care Fellows, and 2 interns. The Surgical Critical Care fellowship is ACGME approved, and the fellows work closely with the residents in all aspects of patient care in the intensive care units.
Burns - The Burn rotation consists of a 4-7 week experience during the PGY II year at Wake Forest Baptist Medical Center’s 8-bed Burn Center. During the rotation, a PGY II is the senior resident involved in the management of burn victims and patients with soft tissue injuries from admission through postoperative follow-up. The rotation is characterized by a multidisciplinary approach to patient care and allows residents an appropriate degree of autonomy in the assessment and management of patients requiring critical care and operative intervention. Residents gain exposure to and comprehension of the diagnosis and management of partial-thickness and full-thickness burn injuries, inhalation injuries, electrical and chemical burns, all facets of critical care, wound care, nutrition, and other sequelae of thermal trauma. The service is enhanced by working closely with the Burn Center director, Dr. James H. Holmes IV and the experienced staff and ancillary services of the Burn Center at Wake Forest Baptist Medical Center.
Emergency General Surgery - The Emergency General Surgery Rotation provides residents with a concentrated experience in the care of patients with emergent surgical problems. The rotation is staffed by the same surgeons that staff the Trauma and Surgical Critical Care rotations, as well as 1 Acute Care Surgery Fellow, 2 PGY-3 residents, and 2 interns. This service provides a unique and concentrated experience with emphasis on decision-making, evaluation, and operative techniques vital in optimal management of these patients.