4Trauma

Professor of Clinical Traumatology, Sir Keith Porter is involved in the treatment of some of University Hospital Birmingham NHS Foundation Trust’s (UHB) most complex injury cases. He trained at St Thomas’ Hospital in London in the 1970s before being jointly appointed at the Birmingham Accident Hospital and Selly Oak Hospital in April 1986. He was awarded a professorship by UHB, the University of Birmingham and the Royal Centre for Defence Medicine in 2005 and was knighted for his role in developing trauma treatment for injured British soldiers in 2010. I am proud of the achievements from the robust civilian-military partnership between the Queen Elizabeth Hospital, Birmingham and the Royal Centre for Defence Medicine, during the last decade. There have been significant advances in pre hospital care with critical care interventions and blood delivered by the MERT team and the introduction of haemostatic resuscitation and damage control principles in Camp Bastion, Afghanistan, such that patients have progressively survived more severe injuries in the last decade particularly as the IED have become more sophisticated and destructive. Birmingham has responded and moved forward the boundaries of continued resuscitation, wound surgery and surgical reconstruction using concepts and techniques that are not in war textbooks and have required bespoke and innovative solutions. Landmark advances have included debridement strategies, proactively managing the continuing inflammatory response, defining and understanding complex microbiological challenges including fungal infections and devising bespoke surgical solutions particularly for soft tissue loss. Integral to improving functional outcome has been our close working with Headley Court. Clinicians have worked closely with DSDL, defence research and the NIHRSRMC to come up with solutions to the research questions these complex patient generate. With several hundred unexpected survivors from recent campaigns, QEHB is proud of the part it has played in the chain of care and is working with the RCDM and defence medical services to capture the lessons learnt in what will be a live and evolving document.