Mil Med. 2026 May 31:usag253. doi: 10.1093/milmed/usag253. Online ahead of print.
ABSTRACT
INTRODUCTION: Military-civilian partnerships are increasingly recognized as necessary to sustain surgical readiness for expeditionary combat casualty care. Because military installations are geographically fixed and may have limited high-acuity case volume, medical readiness depends in part on access to civilian clinical environments. Under a training affiliate agreement, Keesler Medical Center (KMC) general surgeons were integrated into the trauma service at Memorial Hospital at Gulfport (MH), a civilian Level 2 trauma center.
MATERIALS AND METHODS: Non-elective general surgery cases at MH and KMC were compared during calendar year 2025. In addition, trauma activation data from MH were analyzed to characterize day-of-week patterns and the temporal distribution of high-acuity trauma, using blood product administration as a proxy for severity. Weekly clustering was evaluated using chi-square goodness-of-fit testing, and late-week comparisons were assessed using Fisher’s exact testing.
RESULTS: MH generated significantly greater non-elective surgical exposure per weekend call period than KMC (P < .001 using both parametric and non-parametric comparisons). Trauma activations were not evenly distributed across the week (P = .030), with higher volumes observed during mid- to late-week periods. High-acuity trauma demonstrated a similar directional late-week pattern but did not reach statistical significance.
CONCLUSIONS: Integration of military surgeons into a civilian trauma center substantially increased exposure to non-elective and high-acuity surgical care while simultaneously supporting community trauma coverage. These findings suggest that surgical readiness is influenced not only by site-level volume but by exposure density and temporal structure, supporting military-civilian partnership models that deliberately align personnel with high-yield clinical windows.
PMID:42218599 | DOI:10.1093/milmed/usag253
