Vol.:(0123456789) 1 3 Eur J Trauma Emerg Surg DOI 10.1007/s00068-017-0871-x ORIGINAL ARTICLE Preparing Japanese surgeons for potential mass casualty situations will require innovative and systematic programs H. Uchino 1  · V. Y. Kong 2  · J. L. Bruce 2  · G. V. Oosthuizen 2  · W. Bekker 2  · G. L. Laing 2  · D. L. Clarke 2,3   Received: 26 July 2017 / Accepted: 31 October 2017 © Springer-Verlag GmbH Germany, part of Springer Nature 2017 Materials and methods The literature describing the surgi- cal burden from a number of recent military missions was reviewed and the core surgical skills to manage military- type injuries were identifed. We then went on to review all patients admitted to both Kurashiki Central Hospital (KCH) and Pietermaritzburg Metropolitan Trauma Service (PMTS) following trauma between the period September 2015 and August 2016. The burden of trauma at each center was quan- tifed and the number of core surgical competencies or pro- cedures performed at each center was then reviewed. These were then compared with the number of the core procedures which were performed on the reported military missions. Results Three reports on military surgical missions were reviewed. These came from the Dutch, French and Brit- ish military surgical services. The average number of each core procedures performed on each reported military sur- gery mission are tabulated in the text. The most common procedures were wound debridement and orthopedic fxa- tion, followed by trauma laparotomy, neck exploration and thoracotomy. During the 12 month study period, 309 trauma patients were admitted to KCH. Of which 206 (67%) were male, and the mean age was 57 years. There were 10 pen- etrating injuries and 299 blunt injuries. Of the penetrating injuries there were no gunshot wounds. The mechanisms of injury for blunt trauma were as follows: Road trafc acci- dents (RTAs); 141 (47%), fall; 136 (46%) and other inju- ries; 22 (7%). In the same period, 2887 trauma patients were admitted by the PMTS. There were 1244 cases (43%) of penetrating trauma and 1644 cases (57%) of blunt trauma in PMTS. The mechanisms of injury for penetrating trauma were as follows: stab wounds (SWs); 955 (77%), gunshot wounds (GSWs); 252 (20%), and other injuries; 37 (3%) and for blunt trauma were as follows: assault; 739 (45%), RTAs; 669 (41%), fall; 166 (10%), and other injuries; 70 (4%). The exposure to all the key competencies required to manage Abstract Introduction The ongoing state of global geo-political instability means that it is prudent to prepare civilian sur- geons to manage major military-type trauma. Japan has enjoyed a prolonged period of peace and consequently it is unlikely that surgeons will have been exposed to a suf- cient volume of cases. This study reviews the state of trauma training and preparedness in Japan and reviews the trauma workload of a major Japanese emergency medical center and compared with a major South African trauma center with the intention of quantifying and comparing the time needed to gain adequate exposure to major trauma at the two centers. * H. Uchino hayakiu@gmail.com V. Y. Kong victorywkong@yahoo.com J. L. Bruce johnlbruce78@gmail.com G. V. Oosthuizen george.oost@gmail.com W. Bekker bekkerwanda@yahoo.com G. L. Laing grantlaing@me.com D. L. Clarke damianclar@gmail.com 1 Kurashiki Central Hospital, Emergency and Critical Care Center, 1-1-1 Miwa, Kurashiki, Okayama, Japan 2 Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, 719 Umbilo Rd, Durban, South Africa 3 Department of Surgery, University of the Witwatersrand, 7 York Rd, Johannesburg, South Africa