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Optimizing Trauma Care: Evaluating Operating Room Door-to-Incision Using Trauma Video Review
Danielle J Wilson1, Anna Tatakis1, Jaclyn A Gellings1
1Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
The Journal of Surgical Research
|November 26, 2025
Summary
Trauma patients needing rapid hemorrhage control had consistent operating room door-to-incision times (orDTI), regardless of instability. Opportunities exist to improve trauma OR workflows and team coordination for faster surgical intervention.
Area of Science:
- Trauma Surgery
- Surgical Outcomes
- Healthcare Operations
Background:
- Rapid hemorrhage control is vital for trauma patient survival.
- Operating room door-to-incision time (orDTI) is a key metric for preoperative efficiency.
- Hemodynamically unstable patients may have different orDTI.
Purpose of the Study:
- Quantify orDTI in emergent trauma operations.
- Evaluate factors influencing orDTI.
- Identify quality improvement opportunities in trauma care.
Main Methods:
- Prospective analysis of 42 emergent trauma operations using video review.
- Documented preincision activities and abstracted timing data.
- Compared orDTI between stable and unstable patients.
Main Results:
- Median orDTI was 17.0 minutes.
- 36% of cases activated Massive Transfusion Protocol (MTP); 43% had preincision hypotension.
- No significant difference in orDTI for unstable patients (MTP activation or hypotension).
Conclusions:
- orDTI is a valuable metric for trauma care efficiency.
- orDTI was consistent despite patient instability.
- Workflow and team coordination improvements are needed to reduce delays in hemorrhage control.
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