Acute Care Surgery

EVMS Vice Dean for Clinical Affairs and Surgery Chairman, L.D. Britt, MD, MPH, is an international champion of a new tri-discplinary specialty, Acute Care Surgery. He co-author an authoritative text on this emerging surgical field as well as served as Editor-in-Chief on a second text. Acute Care Surgery is a distinct surgical specialty that embodies three surgical components: trauma surgery, emergency surgery, and surgical critical care.

Dr. Britt's leadership led to EVMS Medical Group establishing its Acute and Advanced Care Surgery Service in 2007. Prior to that time, emergently ill patients needing complex surgical procedures were required to leave Hampton Roads for care in larger medical centers. Today, EVMS surgeons see about a thousand patients each year with complex surgical cases. Our referrals come from Hampton Roads physicians, as well as from Northeast North Carolina, Elizabeth City, the Outer Banks, all the way up to the Eastern Shore and as far west as the Franklin area.

"The core principle of acute care surgery is expeditious and effective medical/surgical management, with early diagnosis an essential element. Many of the general principles of trauma management are applicable in the nontrauma setting. However, each specific disease entity has its own unique diagnostic/management paradigm...."

Acute Care Surgery, L.D. Britt, Andrew Peitzman, Philip Barie, Gregory Jurkovich, 2012

 Some examples of conditions that require or benefit from the skills of an Acute Care surgeon:

  • Necrotizing soft tissue infections
  • Bowel perforations
  • Laparoscopic median arcuate ligament release
  • Laparoscopic adrenalectomy
  • Laparoscopic reflux disease
  • Complex abdominal wall hernias
  • Emergency appendectomies, gall bladder, etc.
  • Absecesses
  • Obstructing cancers
  • Vascular and gastyroenterologic conditions
  • Extant co-morbidites, including prior heart disease and high anesthesia risk

Despite the severity and complexity of these and other cases they handle, our Acute and Advanced Care surgeons have a record of superior outcomes and shortened stays. Their multidisciplinary team approach to each individual case means patients have the benefit of every provider's special expertise in complicated medical situations.