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Bringing damage control surgery simulation to life: developing a novel surgical anatomy model within immersive military trauma surgery simulation
  1. C S Swain1,
  2. H M L Cohen2,
  3. A Stannard3,
  4. E R Faulconer4 and
  5. I Pallister5
  1. 1Institute of Naval Medicine, Gosport, UK
  2. 24 Armoured Medical Regiment, Camberley, UK
  3. 3Vascular Surgery, James Cook University Hospital, Middlesbrough, UK
  4. 4Vascular Surgery, Derriford Hospital, Plymouth, UK
  5. 5Trauma & Orthopaedic Surgery, Cardiff and Vale University Health Board, Cardiff, UK
  1. Correspondence to C S Swain, Institute of Naval Medicine, Gosport PO12 2DL, UK; cara.swain{at}


Haemorrhage from junctional injuries remains the most common cause of battlefield death. Changes to surgical training have meant acquiring and maintaining trauma surgical skills is becoming more difficult for military surgeons. The multidisciplinary Military Operational Specialist Team Training (MOSTT) course is designed to bridge the gap between civilian practice and the deployed environment, as part of predeployment trauma training. It involves immersive team simulation and uses cadaveric dissection for surgical skills practice.

A novel surgical anatomy model, featuring junctional haemorrhage surgical task trainers of the groin and shoulder, was designed using reconstructed CT and MRI images obtained from a human volunteer. The model is designed to look and feel as realistic as possible, with the added dimension of pulsatile ‘blood’ flow from a simulation gunshot injury.

This surgical anatomy model has been trialled, as part of the MOSTT course, by 90 surgeons and perioperative practitioners, with feedback analysis used for iterative model development. Feedback demonstrated that, alongside more traditional cadaveric dissection, this surgical anatomy model adds value to current predeployment training delivered within the immersive simulation of the MOSTT course. Research by the authors about the effects of this model on surgical ability and performance is ongoing. However, there is clear potential for this model to be used in other environments, including on exercises and as part of consolidation training while deployed.

  • surgery
  • medical education & training
  • trauma management

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  • Contributors IP is responsible for methodology, iterative development of the model and planning integration to the MOSTT course with ERF and AS. CS performed data collection and analysis, assisted by HMLC. CS wrote the manuscript with all authors contributing significantly throughout the editing process.

  • 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.