In the United States, trauma centers are stratified into five levels (Level I to Level V) based on the available resources for the care of patients with traumatic injuries, defined as the sudden onset of physical injury requiring immediate medical attention. Emergency departments (EDs) in Level I trauma centers typically manage a substantial patient load, with wound care constituting a critical service provided nationwide. A study by Cross et al examined 60,345 patients in a sizable public ED in a metropolitan area over a 12-month period, revealing that approximately 6% required wound care, a prevalence observed throughout the country.

In the context of a high-volume ED, the strategic training of technicians to administer fundamental wound care, including cleansing, bandaging, and superficial wound closure, enables ED physicians to allocate their expertise to more complex cases. This initiative seeks to elucidate the organizational structure of the Suture Tech Program (STP) at the University of Tennessee Health Science Center (UTHSC). The STP is meticulously designed to equip medical students with the requisite skills to deliver these interventions under the direct supervision of physicians in the ED.

We conducted an insightful interview with Thomas Triplett, MD, an ED physician at Regional One and the current chief of the STP. Additionally, we actively participated in numerous shifts to gain firsthand insights into the program’s design. Regional One, affiliated with UTHSC, serves as the sole Level I Trauma Center within a 150-mile radius of Memphis, TN, attending to an estimated 34,499 patients between July 2016 and June 2018. Originating in the 1990s, the STP was established to alleviate ED congestion while unwaveringly maintaining the standard of care for patients. The program comprises 15 meticulously trained medical students from the second to fourth year at UTHSC, each undergoing approximately 150 hours of training before actively contributing to basic wound care under the judicious guidance of ED physicians. Operating from 6 pm to 12 am on Sunday to Thursday, and from 6 pm to 6 am on Friday and Saturday, the program has witnessed a noteworthy proportion of participants advancing to graduate and securing placements in surgical subspecialties. It is our fervent hope that by providing a comprehensive overview of the STP’s structure, other programs nationwide, if deemed necessary, can draw upon its success for emulation.

References and Resources

1. American College of Surgeons Committee on, T., Statement on trauma center designation based upon system need. Bull Am Coll Surg, 2015. 100(1): p. 51-2.
2. Southern, A.P. and D.H. Celik, EMS, Trauma Center Designation, in StatPearls. 2023: Treasure Island (FL).
3. Cross, R., et al., Profiling wound management in the emergency department: A descriptive analysis. Australas Emerg Nurs J, 2016. 19(3): p. 166-71.
4. , C., et al., Management of traumatic wounds in the Emergency Department: position paper from the Academy of Emergency Medicine and Care (AcEMC) and the World Society of Emergency Surgery (WSES). World J Emerg Surg, 2016. 11: p. 30.
5. Otterness, K. and J.S. A, Updates in emergency department laceration management. Clin Exp Emerg Med, 2019. 6(2): p. 97-105.
6. Quinn, J.V., S.K. Polevoi, and M.A. Kohn, Traumatic lacerations: what are the risks for infection and has the ‘golden period’ of laceration care disappeared? Emerg Med J, 2014. 31(2): p. 96-100.
7. Yamamoto, R., et al., Early Complications Following Facial Laceration Repair Performed by Emergency Physicians After One Year of Wound Closure Training. AEM Educ Train, 2018. 2(4): p. 259-268.
8. Vaida, B.L., For The Uninsured In Memphis, A Stronger Safety Net. Health Aff (Millwood), 2019. 38(9): p. 1420-1424.