WELCOME FROM ATMS On behalf of the organising committee, we are delighted to welcome you to Glasgow for the Association of Trauma & Military Surgery Annual Conference. ATMS was founded in 2012, in recognition of the emergence of ‘trauma surgery’ as a general surgical speciality in its own right in the UK and reflecting the contribution that military surgery has made to trauma care.

This is the first year that our abstract submission process has been fully integrated with ASGBI and, whilst there have been a few minor teething troubles, the volume and standard of abstract submissions has been unprecedented. Integration within ASGBI means that the quality of our meeting is improving year-on-year, and we are pleased to have attracted submission from surgeons from many different nations. In addition to the selected free papers, ATMS welcomes our keynote speaker, Professor C William [Bill] Schwab from the University of Pennsylvania. Bill Schwab has an enviable reputation as one of the finest trauma surgeons in the world, and we are genuinely delighted that he is going to share his journey in Damage Control Surgery with us during the annual Guthrie Lecture. In addition, he is speaking in our Thursday ATMS session about management of gunshot injuries; surely these are unmissable sessions for those of us interested in trauma management. We have a stellar supporting cast of distinguished speakers; Mr Rod Dunn, Consultant Plastic and Reconstructive surgeon at Salisbury will talk about his experiences of integrating specialist NHS care into treatment pathways for severely injured service people; Dr Jackson KirkmanBrown, MBE, Reader in Reproductive Science at The University of Birmingham and Director at The Centre for Human Reproductive Science, will discuss his ground-breaking work in preservation of male fertility after devastating urogenital injury; Mr David Nott, OBE is sharing his experience of Damage Control Surgery in the austere environment, and Dr Harald Veen, lead surgeon for the International Committee of the Red Cross/Red Crescent is going to talk about the opportunities for trauma practitioners that are possible within that great humanitarian organisation.

PROGRAMME

We are proud to have been recognised as a specialty association by the Association of Surgeons of Great Britain and Ireland, with representation on the ASGBI Council, and are extremely happy to be an integral part of this year’s International Surgical Congress.

We hope that you will join us at the official ATMS dinner on the evening of Wednesday 1st May, at the Scottish National Piping Centre, where we hope you will have the opportunity to unwind and enjoy some social networking amongst like-minded trauma care providers and our guests. As a brand-new specialty association, ATMS needs to appoint ‘office bearers’ to help take the organisation forward. We would, therefore, ask you to join ATMS (details at www.atms.org.uk), attend the ATMS business meeting scheduled for 13.10 on Wednesday 1st May in the Leven Room, and put yourselves forward for election; the success of ATMS depends on the energy and enthusiasm of its participants. ATMS wishes to thank The Royal British Legion for its generous sponsorship of the Guthrie Lecture; their help enables us to attract international speakers of the highest quality. We also gratefully acknowledge the annual Jenkins Travelling Fellowship, a £1,500 grant which enables a trainee in surgery to visit a specialist centre or conference (full details on the ATMS website). We hope you enjoy the 2013 Conference! Association of Trauma & Military Surgery 1

Wednesday 1st May 2013

ASSOCIATION OF TRAUMA & MILITARY SURGERY CONFERENCE 2

Surgeon Commander Rory Rickard, PhD, FRCS(Ed), FRCS(Eng), FRCS(Plast), RN Rory Rickard is a Consultant Burns and Plastic Surgeon at MDHU Derriford, where his clinical interests include soft tissue sarcoma and lower limb trauma and reconstruction. He graduated from the Queen’s University, Belfast in 1992. General duties in the Royal Navy were conducted on Frigates and Destroyers and with the Royal Marines. He has served on operations in the Former Republic of Yugoslavia, in Northern Ireland, and in Iraq and Afghanistan. He conducted his higher surgical training in Bristol, Cape Town and Glasgow. Research into a multi-dimensional in vivo, ex vivo and in silico investigation into the management of arterial size discrepancy in supermicrosurgery led to a PhD from the Universities of Cape Town and Glasgow. He is a Senior Lecturer in the Academic Department of Military Surgery and Trauma, with a portfolio covering wounds and burns. He is a visiting Senior Lecturer in Plastic and Reconstructive Surgery at the University of Stellenbosch, South Africa, where he runs a research programme investigating the modelling of haemodynamics in microvascular surgery. He is the Royal Navy’s Consultant Adviser in Burns and Plastic Surgery. Mr Roderick Dunn, MBBS, DMCC, FRCS(Plast) Rod Dunn is a Consultant Plastic, Hand and Reconstructive Surgeon at Odstock Hospital in Salisbury. After qualification from Charing Cross and Westminster Medical School in 1989, Rod served as a Royal Navy and Royal Marines Medical Officer. He then trained in plastic surgery in Derriford, Frenchay and Canniesburn Hospitals. He was the first Visiting Fellow in hand and microsurgery at Ganga Hospital in India in 2002, and then spent two years in Leeds as the Microsurgery and Hand Fellow. His interests are in reconstructive hand surgery, children’s hand surgery and microsurgical limb reconstruction and peripheral nerve surgery. With Professor Rolfe Birch, and plastic surgery colleague Miss Alex Crick, he has visited the Defence Medical Rehabilitation Centre, Headley Court for the last five years to help in reconstruction of war injuries from Iraq and Afghanistan. His work in the field was recognised with the award of “Healthcare

Civilian of the Year” in the Military and Civilian Health Partnership Awards 2011. Mr Dunn is on the Faculty of the Royal College of Surgeons of England Basic and Advanced Hand Surgery Courses, and the Organising Committee for the BSSH Instructional Courses in Hand Surgery. Lieutenant Colonel Douglas M Bowley, MBBS, FRCS(Gen Surg), RAMC Doug Bowley is a consultant general and colorectal surgeon at the Royal Centre of Defence Medicine in Birmingham and Chair of the organising committee of the Association of Trauma & Military Surgery. He qualified from St Thomas’s Hospital in London and has undertaken surgical training in the UK and South Africa. An enthusiastic surgical educator, he is editor of the popular text, Fundamentals of Surgical Practice. He has deployed to Iraq and Afghanistan. He has recently been appointed as Consultant Adviser in Surgery to the Director General of the Army Medical Service. Professor C William Schwab, MD, FACS, FRCS Professor Schwab has made many contributions to trauma care, predominantly in education, systems of care, injury prevention, governance and leadership. In the 1980s, he and the University of Pennsylvania team pioneered many aspects of the Damage Control approach to lifethreatening injury, now integral to the trauma care world-wide. He established trauma and surgical critical-care fellowships for national and international trauma training, a programme that has graduated >120 alumni from around the globe. Professor Schwab has held a professorship at Penn since 1987 and holds honorary memberships in the Swedish Surgical Association, European Society of Trauma and Emergency Surgery and the Royal College of Physicians and Surgeons of Glasgow. Bill has contributed to over 200 peer-reviewed publications, edited or co-edited four textbooks and is Past President of the American Association for the Surgery of Trauma (AAST), the Eastern Association for the Surgery of Trauma and the International Association for Trauma Surgery and Intensive Care. In 2008, he was awarded the National Safety Council Surgeons Award for Service to

Mr Jonathan Reynolds, MBChB, DM, FRCS, FRCS(Ed) Jonathan Reynolds is a consultant colorectal and general surgeon at Derby, UK. He is a consultant trauma surgeon at Queens Medical Centre Nottingham and a consultant surgeon with 212 Filed Hospital, Royal Army Medical Corps. He has seen active service in Afghanistan, and is due to deploy again this year. He has a major medico-legal practice, which sustains his interest and involvement in clinical governance and safety in surgical practice. Lieutenant Colonel Nigel Tai, MBBS, MD, FRCS(Gen Surg), RAMC Nigel Tai was appointed as consultant in trauma and vascular surgery at the Royal London Hospital in 2006. He qualified from University College London in 1991, and undertook surgical training in London and Johannesburg, South Africa. With extensive experience of deployed surgery, he is an Honorary Senior Lecturer at the Academic Department of Military Surgery and shortly to deploy as Medical Director to the Joint Force Hospital in Helmand, Afghanistan. Dr Jackson KirkmanBrown, MBE, PhD Jackson Kirkman-Brown is Science Lead at Birmingham Women’s Fertility Centre; a Reader in Human Reproductive Biology at the University of Birmingham and the Secretary of the British Andrology Society. As Director of the Centre for Human Reproductive Science (ChRS) he leads a strong interdisciplinary research group in reproduction. Jackson studied for his BSc in biological sciences (animal) and PhD in human sperm signalling at the University of Birmingham. Jackson then carried out postdoctoral research at the University of

Massachusetts Medical School, MA, USA before returning to the UK. Jackson’s team undertake experimental research in how human sperm swim and signals between them and the female tract; having collaborations that include developing the world’s first accurate home-sperm-test; new ways of freezing sperm; and psychological aspects of fertility. Jackson is actively engaged in communicating science to the public, regularly having been involved with BBC World Service documentaries and various television projects, including most recently Embarrassing Bodies. Jackson was appointed an MBE in the Queen’s New Year Honours for Services to Clinical Reproductive Medicine particularly focused on work with testicular trauma in injured servicemen. Mr David Nott, OBE, BSc, MD, FRCS David Nott gained his medical degree at Manchester University. He later attended the Royal College of Surgeons in London to become a Consultant Surgeon in 1992. He has been a Consultant Surgeon at Chelsea & Westminster Hospital for nearly 15 years. Mr Nott is also specialised within vascular surgery and is an authority in laparoscopic surgery - in particular AAA repairs and distal arterial bypasses. He is the first surgeon to combine laparoscopic and vascular surgery. In addition, he spends a few months every year working for Médecins Sans Frontières and the British Red Cross. He has recently dedicated his time to helping those affected by war, (Darfur, Afghanistan, Iraq, Syria) and by natural disasters, including the victims of the devastating earthquake in Haiti.

SPEAKERS

Safety, for his long and distinguished work addressing the toll of gun violence in America. At Penn, he established the Firearm and Injury Center (FICAP), a group pivotal in addressing the magnitude of risks of handgun ownership and recovery from gun violence. Professor Schwab has served as a Commander in the United States Navy and remains active with the Department of Defense and Military Medical Training programmes.

Harald Veen, FRCSEd Harald Veen is a Consultant General Surgeon registered in the Netherlands in 1992, and in the UK in 2002. He practiced oncological, vascular and trauma surgery in the Netherlands from 1992 until 2002. After this he focussed more on trauma surgery, from 2003 to 2006 for the NHS in the UK, and from 2006 to 2012 for the Royal Navy in Gibraltar. Between 1992 and 2012 he took part in around 30 missions for ICRC in war zones around the world. He was previously an Advanced Trauma Life Support (ATLS) instructor, and more recently, Definitive Surgical Trauma Skills (DSTS) instructor. Since 2012, he has been Head Surgeon for the International Committee of the Red Cross in Geneva. 3

Wednesday 1st May 2013

ASSOCIATION OF TRAUMA & MILITARY SURGERY CONFERENCE LEVEN ROOM EARLY MORNING 8:00

LATE MORNING 11:00

REGISTRATION, COFFEE AND INDUSTRY EXHIBITION

Session 2: PLENARY GUTHRIE LECTURE

9:00

IN LOMOND AUDITORIUM

9:00

Chair: Lt Col Douglas Bowley, RAMC Invited Speaker: DAMAGE CONTROL - THE ODYSSEY Professor C William Schwab, MD, FACS, FRCS Division of Traumatology, Surgical Critical Care & Emergency Surgery, Hospital of the University of Pennsylvania, Philadelphia, U.S.A.

Session 1: ATMS SYMPOSIUM Chair: Surg Cdr Rory Rickard, RN

SPONSORED BY THE ROYAL BRITISH LEGION

Free Papers: 6 + 3 minutes Invited Speaker: CIVILIAN - MILITARY COOPERATION IN THE RECONSTRUCTION OF COMPLEX TRAUMA Mr Roderick Dunn, MB BS, DMCC, FRCS (Plast) Odstock Centre for Burns, Plastic & Maxillofacial Surgery, Salisbury, UK

12:00 12:00

BREAK

12:10 12:10 Session 3: ATMS SYMPOSIUM Chair: Mr Jonathan Reynolds, MBChB, DM, FRCS, FRCS (Ed) Free Papers: 6 + 3 minutes

13:10

10:30 10:30 11:00 4

COFFEE BREAK AND INDUSTRY EXHIBITION

13:10 ATMS ANNUAL GENERAL MEETING

13:20

Wednesday 1st May 2013

ASSOCIATION OF TRAUMA & MILITARY SURGERY CONFERENCE LEVEN ROOM EARLY AFTERNOON 13:20

LATE AFTERNOON 16:00 Session 5: ATMS SYMPOSIUM

LUNCH BREAK AND ASGBI INDUSTRY EXHIBITION

14:10

Free Papers: 6 + 3 minutes

14:10

Invited Speaker: DAMAGE CONTROL IN THE AUSTERE ENVIRONMENT Mr David Nott OBE Consultant General Surgeon, Chelsea & Westminster Hospital

Session 4: ATMS SYMPOSIUM

Invited Speaker: OPPORTUNITIES FOR TRAUMA SURGERY WITH RED CROSS / RED CRESCENT

Chair: Lt Col Nigel Tai, RAMC Free Papers: 6 + 3 minutes Invited Speaker: PRESERVING FERTILITY AFTER SEVERE GENITAL TRAUMA Dr Jackson Kirkman-Brown, MBE, PhD Director of the Centre for Human Reproductive Science at the University of Birmingham, UK

Dr Harald Veen Head Surgeon, International Committee of the Red Cross (ICRC), Geneva, Switzerland

17:30 17:30 PRESENTATION OF PRIZES AND CLOSE OF CONFERENCE

17:40 19:15 15:30 15:30 16:00

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ATMS CONFERENCE BLACK TIE DINNER The National Piping Centre, Glasgow

TEA BREAK AND INDUSTRY EXHIBITION

20:00 5

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ASSOCIATION OF TRAUMA & MILITARY SURGERY CONFERENCE

SHORT PAPER PRESENTATIONS SESSION 1: ATMS SYMPOSIUM

SESSION 4: ATMS SYMPOSIUM

Chair: Surg Cdr Rory Rickard, RN

Chair: Lt Col Nigel Tai, RAMC

09:00

The role of deployed plastic surgeons: A three year evaluation. Mr Shehan Hettiaratchy

13:00

09:10

Tissue stabilisation and preservation in Vascularised Composite Allotransplantation (VCA): Current concepts. Dr Charles Fries

Management of Complex Abdominal Wall Problems associated with penetrating abdominal trauma. Benefits of Skin Traction Sutures. Mr Suren Arul

14:10

A decade of UK Combat Casualties in Iraq and Afghanistan 2003 to 2012. Dr Jowan Penn-Barwell

14:20

Changes in blood transfusion practices in the UK role 3 medical treatment facility in Afghanistan, 2006 - 2011. Mr Jan Jansen

14:30

Is there a need for military hand transplantation? Mr Shehan Hettiaratchy

Initial surgical management of abdominal injury in deployed military hospitals: Damage control now dominates. Mr Iain Smith

14:40

Major Trauma Centres: The Impact on Plastic Surgery Manpower and Implications for the Future. Dr Graham Lawton

Can splenic blush on Multi Detector CT (MDCT) predict outcome in splenic injury? Mr Mansoor Khan

14:50

Systematic review and meta-analysis of randomised controlled trials comparing primary versus delayed primary skin closure in contaminated and dirty abdominal incisions. Mr Prashant Singh

09:20

Are we right to BOAST? Looking at open fracture care in North West London. Dr Graham Lawton

09:30

Long-term outcomes following lower limb salvage in a UK military cohort injured in combat operations in Iraq and Afghanistan. Dr Daniel Ablett

09:40

09:50

SESSION 3: ATMS SYMPOSIUM Chair: Mr Jonathan Reynolds 12:10

Improvements in the Haemodynamic Stability of Combat Casualties during En-Route Care. Mr Jonathan Morrison

12:20

“Proximal control”: Utilisation and complications of operative control of arterial inflow in combat casualties with traumatic lower extremity amputations caused by improvised explosive devices. Dr Henrietta Poon

12:30

The physiological effects of 60 minutes of Resuscitative Aortic Balloon Occlusion of the Aorta in a haemorrhagic swine model. Dr Robert Houston

12:40

Prospective Evaluation of CT Aortic Morphometry with Torso Height with Regard to a Fluoroscopy Free Aortic Balloon Occlusion System. Mr Jonathan Morrison

12:50

Severe open femoral fractures in combat trauma: Management and preliminary outcomes. Dr Philippa Bennett

SESSION 5: ATMS SYMPOSIUM Chair: Lt Col Douglas Bowley, RAMC 16:00

Surgical skill sets necessary in a British military hospital in Southern Afghanistan are essential also in a Norwegian Role 2 hospital in Northern Afghanistan. Mr Petter Iversen

16:10

Multiple Limb Loss following Combat Injury in the British Military. Dr Jowan Penn-Barwell

16:20

The ‘Trauma WHO’ for Optimising Communications in the Damage Control Resuscitation - Damage Control Surgery sequence (DCR-DCS). Introduction to the Role 3 Hospital at Camp Bastion. Mr Suren Arul

16:30

Contemporary use of expanded polytetrafluoroethylene (ePTFE) as a conduit for vascular reconstruction in combat casualty care. Dr J Devin B Watson

PROGRAMME

Ground Floor

First Floor

7

What are QR Codes? QR (Quick Response) codes are images that can be ‘read’ by any Smartphone or Tablet that is equipped with a camera and a QR reading app. QR codes are similar to barcodes, insofar as they contain encoded information, although it is possible to embed much more detail in a QR code. To read a QR code, you need to download and install a QR Reader App, and there are numerous free apps available through your preferred App store.

Wednesday 1st May 2013

ASSOCIATION OF TRAUMA & MILITARY SURGERY CONFERENCE

QR CODES AT THE 2013 ATMS CONFERENCE

How can the QR Codes in this ATMS Programme booklet be used? If you scan the codes for the sessions you attend with your Smartphone QR reader, you will be able to keep a record of the date and time, the title of the session and the speaker(s). You will be then able to import this data into a spreadsheet, text file or database, so you can have a readymade - personalised - record of your CPD/CME activity.

So how can I use the QR code facility for myself? You will need to download a QR Reader App onto your Smartphone. There are several available, including the popular app ‘NeoReader’, which works on Apple, Android and other platforms. Search for ‘NeoReader’ from your App site and download it for free. Once installed, open the App, point your phone at the code, and off you go!

Where do I find, and how do I extract, the data I have scanned with my QR Reader? Your QR Reader will store the scanned data within the App’s ‘history’. This information - a record of your CPD/CME activity - can then be exported into a programme such as a word processor or spreadsheet. We hope you enjoy using the QR codes at this year’s ATMS Conference, and would welcome feedback on ways to make this tool more effective.

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11:00

13:20

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15:30 ATMS ANNUAL GENERAL MEETING

13:10

TEA BREAK AND INDUSTRY EXHIBITION

20:00

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19:15

17:40

17:30

16:00

17:30

10:30

COFFEE BREAK AND INDUSTRY EXHIBITION

Chair: Lt Col Nigel Tai, RAMC

Session 4: ATMS SYMPOSIUM

LUNCH BREAK AND ASGBI INDUSTRY EXHIBITION

Chair: Mr Jonathan Reynolds, MBChB, DM, FRCS, FRCS (Ed)

14:10

14:10

13:20

EARLY AFTERNOON

Session 3: ATMS SYMPOSIUM

BREAK

Chair: Lt Col Douglas Bowley, RAMC

IN LOMOND AUDITORIUM

Session 2: PLENARY GUTHRIE LECTURE

15:30

12:10

12:10

12:00

12:00

11:00

13:10

Chair: Surg Cdr Rory Rickard, RN

Session 1: ATMS SYMPOSIUM

REGISTRATION, COFFEE AND INDUSTRY EXHIBITION

LATE MORNING

10:30

9:00

9:00

8:00

EARLY MORNING

The National Piping Centre, Glasgow

ATMS CONFERENCE BLACK TIE DINNER

PRESENTATION OF PRIZES AND CLOSE OF CONFERENCE

Session 5: ATMS SYMPOSIUM

LATE AFTERNOON

Wednesday 1st May 2013

ASSOCIATION OF TRAUMA & MILITARY SURGERY CONFERENCE LEVEN ROOM

Wednesday 1st May 2013

ASSOCIATION OF TRAUMA & MILITARY SURGERY CONFERENCE LEVEN ROOM

ASSOCIATION OF TRAUMA & MILITARY SURGERY ANNUAL CONFERENCE

Association of Trauma and Military Surgery 35/43 Lincoln’s Inn Fields London, WC2A 3PE. United Kingdom. Tel: +44 (0)20 7304 4778 Email: [email protected] • Web: www.atms.org.uk