Jacobs Journal of Emergency Medicine

The Next Paradigm Shifts In Japan: “Trauma Surgery” and “Acute Care Surgery”

Published on: 2014-03-07


The field of trauma surgery has shifted from invasive trauma surgery to non-operative management, which has been represented by “trauma incision” Compared with other countries, there are few trauma surgeries in Japan; therefore, maintaining the necessary techniques and skills is our current, biggest problem. We rarely encounter serious trauma cases that necessitate surgeries because there are no large trauma centers. Furthermore, according to the Japanese Trauma Data Bank (JTDB), penetrating types of trauma are uncommon, and gunshot wounds accounted for only 33 patients (0.04% of overall trauma patients) in five years (2008–2012). Most trauma surgeons in Japan have not treated a patient with a gunshot wound. Notably, the JTDB reported that the incidence of preventable trauma death reached approximately 20.5% in the studied period. Although preventable trauma deaths gradually decreased, we cannot say that the standard treatment of trauma has widely improved throughout Japan. The opportunity to treat severe trauma cases has decreased; thus, we cannot gather enough cases at one trauma center in Japan. The concept of acute care surgery appeared to solve.


Trauma Surgery, Acute Care Surgery, gunshot wounds, trauma incision