Unless dealing with injury regularly, few surgeons can attain and sustain the level of skill necessary for decision making in major trauma. This includes both the intellectual decisions and the manual dexterity required to perform all the manoeuvres needed for surgical access and control. These can be particularly challenging, and may be infrequently required, yet rapid access to and control of sites of haemorrhage following trauma can be life-saving surgical intervention. Many situations require specialist trauma expertise, yet often this is simply not on hand within the available time frame. Manual of Definitive Surgical Trauma Care, Second Edition, is written by the editorial board of the DSTCTM, which is a short course focusing on the life-saving surgical techniques and surgical decision-making required for surgeons who deal with major surgical trauma on an infrequent basis. This course supplements the well-recognized and accepted American College of Surgeons' Advanced Trauma Life Support (ATLS(r)) course. This manual is published in association with IATSIC (the International Association for the Surgery of Trauma and Surgical Intensive Care), and is written by an Editorial Board of surgeons who belong to that society. IATSIC are broadening their reach and running more and more courses worldwide. This new second edition has been updated to incorporate all recent developments in this rapidly progressing area. It emphasizes how practical 'real-life' decisions on the care of the injured patient should be made and then covers in practical terms the surgical techniques required. Every aspect of surgical trauma care is covered, including: * the causation of injuries - aids rapid understanding of presented trauma; * the initial, pre-hospital and emergency department care of the patient - all of which may determine eventual outcome; * the resources required, both physical and intellectual, within the hospital to deal with the specific problems associated with patients with multiple injuries; the limitations in providing specialist expertise within the time frame required. It is an ideal practical manual for both trainees and qualified surgeons.