CRITERIA FOR INCLUSION

IN A EUROPEAN EMERGENCY HAND TRAUMA NETWORK
(HTC – 2021)

 

DEFINITION OF HAND TRAUMA

Any closed or open injury to the wrist and/or the hand, substantially involving skin, muscle, tendon, bone and joint, nerve and/or vessels

HAND TRAUMA SURGEON

A hand trauma surgeon is a surgeon who

  1. has a significant involvement in hand trauma surgery,
  2. is a member of a National Hand Surgery Society which is either a full or associate member of FESSH and
  3. has an official microsurgical qualification.

A HAND TRAUMA AND REPLANTATION CENTER (HTRC)

A HTRC is a center, which

  • provides a 24/24 emergency service,
  • is supported by at least 3 Hand Trauma Surgeons (as stated above) and rehabilitation services (at least one European Certified Hand Therapist – ECHT is recommended to be employed).
    • One of these surgeons (not necessarily the clinical head) will be a nominated HTC delegate who represents the center at the HTC and is responsible for all the communications with the HTC.
    • From 2019, at least one of the surgeons must have obtained the EBHS Diploma.
  • The number of treated cases should be at least 40 cases per 3 month per center, including 10 microsurgical cases (including nerve repair).
  • The service should have access to adequate facilities for managing complex hand trauma including all of the following types of surgical techniques: revascularization and replantation / flaps / nerve repair

The HTRC will receive a certificate from FESSH and will be subject to random visitation (audit).

A HAND TRAUMA UNIT (HTU)

A Hand Trauma Unit (HTU) is part of the trauma network; is defined as a unit

  • with at least two hand trauma surgeons (as stated above) who have access to daily operating facilities dedicated to hand trauma.
  • The number of treated cases should be at least 150 trauma cases per year.
  • The unit must be able to provide early, specialized rehabilitation. It is recommended to employ one European Certified Hand Therapist (ECHT) in the unit.

The HTUs will not be audited and certified by FESSH. The national HTC representatives can check with the help of their national society data given by the HTU.

 

These criteria for not emergency level trauma network are suitable of changing once a year. In the future the EBHS Diploma for one of the surgeons will be essential in all trauma structures. Our expectation is that all Hand Trauma and Replantation Centers and Hand Trauma Units joining the trauma network will be involved in the critical evaluation of their performance by:

  1. Collecting a database of patients treated
  2. Monitoring outcomes of their treatments
  3. Attendance at regular local morbidity meetings,
  4. Delivering research publications
  5. Delivering presentations to FESSH
  6. Offering Teaching and Training opportunities such as microsurgical training, a teaching program, and fellowship opportunities.