William Beaumont Army Medical Center hosted Army Trauma Training Center's Combat Extremity Surgery Course (CESC) in coordination with Texas Tech University Health Sciences Center in El Paso, Texas, Feb. 2-3.The course provided deploying surgeons, physician assistants, nurse practitioners and combat medics from all over the Army with the training and skills necessary to increase readiness and manage extremity trauma in a deployed environment."The course is specifically designed to prepare the Soldiers for the care of wounded while deployed," said Lt. Col. Mark McAndrew, director, CESC. "This is only the second iteration where we've practiced a specific model of removing tissue and cleaning debris that has blown into a wound from the ground."In addition to providing healthcare providers improved ability to treat Soldiers in austere surroundings, the course instructs healthcare providers on the treatment of injuries ranging from blast trauma and burn management to external fixation and amputation."We teach them the basic surgical skills needed to take care of combat wounded," said Col. Mark Pallis, chairman, Department of Orthopaedic Surgery, WBAMC. "If they are out in some austere environment with limited equipment, they utilize this training to stabilize the patients and get them to a higher echelon of care."Front-line medical providers often evacuate Soldiers to a higher echelon of care for more definitive treatment. While mode of evacuations for each casualty may differ, preventing further patient distress is important during evacuation."Over 80 percent of combat-injured patients have an extremity injury," said Pallis. "It's very important that our (medical) Soldiers know how to effectively manage extremity treatment."The course also evaluated Soldiers' ability to utilize surgical field kits to apply external fixators to stabilize patients with fractures prior to evacuation. Real-life training to increase readiness on the battlefield was available to the Soldiers as they practiced wound debridement (cleaning) and external fixation procedures on cadaver limbs."(The hands-on training) included debridement of dirt and foreign material out of the wounds as well as using the external fixator to temporarily stabilize the patient's fracture to allow for some soft tissue rest during transfer," said Pallis. "This is for the austere, front-line, (first and second echelons of care) type of surgeries."