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Management and prevention of surgeon skill decay during US military deployment: a response to the UK
  1. Cade A. Morris,
  2. J H Beery and
  3. D J Stinner
  1. Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  1. Correspondence to Mr Cade A. Morris, Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37240, USA; cade.morris{at}

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We commend Stansfield and Tai for their article “Skill decay in surgeons deployed on military operations: a systematic review”.1 The authors conducted a thorough systematic review investigating the impact low combat casualty care (LCCC) deployments have on surgeon skill and patient outcomes. The authors highlight the need for a validated set of tools to assess skill decay and propose mitigation strategies, such as individualised skill maintenance plans and non-tissue simulations. Furthermore, the authors discuss the difficulties in investigating and implementing such tools and strategies. In light of recent studies further illustrating low surgical case volume during deployments, to include surgical subspecialists,2 we had additional thoughts and questions which may help drive future research and inform the way surgeons …

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  • Contributors CM, JB and DJS all equally contributed to the analysis of initial article, response formulation and multiple manuscript drafts. CM and DJS equally contributed to the final edits with submission being managed by CM.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.