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Almost 30 years ago, two ambitions and competitive surgeons, both of whom had received some specialized advanced training in cardiovascular surgery and surgical research, were acquiring reputations in the exploding field of “trauma.”

Physicians and physiologists have been interested in the field of trauma for thousands of years, as manifest by the earliest of surgical writings, the Edwin Smith Surgical Papyrus, in which almost all case studies focused on the injured patient. The explosion of interest in trauma during the 1970s and 1980s was brought about by the simultaneous juxtaposition of many factors:

• EMS development
• Emergency medicine as a specialty
• Critical care as a discipline
• Increased sophistication in human physiological monitoring
• Advances in blood banking and hemotherapy
• Advances in vascular surgery
• Surgeons returning from the Vietnam conflict
• Broadening the scope of military medicine via the Uniformed Services University of the Health Sciences
• Last, but far from least, a large group of young, aggressive, eager surgeons who enjoyed the challenge of taking care of acutely injured patients with severe anatomic and physiological derangements

During the 1970s and early 1980s, trauma textbooks available to an aspiring academic surgeon or a practicing community surgeon seeking to master new techniques were few and rather limited in scope. Most recommendations contained therein were based on “expert opinion” and trial and error, rather than any evidence-based approach. Injury classification was in its infancy, and quality management matrix analyses had yet to be described. Almost simultaneously, Doctor Kenneth Mattox, in Houston, and Doctor Ernest Eugene (Gene) Moore, in Denver, recognized “there has to be a better way and a better textbook.” Doctors Moore and Mattox, independently and unbeknownst to each other, began to construct outlines for a practical trauma book employing the leading “trauma surgeons” of the day to contribute.

While both were in the challenging “convincing stages” with their respective publishers, they were assembling a group of authors to participate in their respective endeavors. At this point, they discovered, they were pursuing similar projects and recruiting similar authors. A major merger followed, and at our initial meeting, the current format for the book Trauma was born. David Feliciano was invited to be the third editor, and the legacy began. We agreed to rotate the first editor spot with each subsequent edition, and the subsequent six editions are history. During the past 30 years, Trauma has been the dominant textbook in its field throughout the world. It led in the fields of surgical critical care and acute care surgery, long before these were disciplines. This Seventh Edition marks a milestone in a textbook that continues to be the best seller in its field and have the same three medical editors.

Since the mid-1980s, we have seen many changes in our society, medicine, and surgery, in general. HIV and AIDS introduced new immunological and treatment dilemmas. Inflammatory mediators, cytokines, and immunomodulation have grown into scientific fields, all their own. The wars in the Middle East have underscored the contemporary changes in trauma management. We have witnessed the emergence of damage control surgery and staged treatment. The most pronounced aspect of this concept is the ability to transport combat causalities across continents after initial damage control treatment, administer intermediate treatment in a European military hospital, and then transport, again, in a literal flying ICU. During the growth and development of Trauma, trauma center verification, designation, and recognition have become widespread. The terms Level I, Level II, and Level III Trauma Centers are now commonplace, and society expects every major city to have appropriate trauma treatment capability. Tenets of aggressive crystalloid resuscitation, precontrol elevation of the blood pressure, and other traditional aggressive resuscitation cultures have changed dramatically.

Each edition of Trauma is different from the previous one. In preparing for the Seventh Edition and this preface, I reviewed each edition, chapter by chapter. For this edition, as in previous ones, we have invited new authors for many chapters, and we requested that the number of references be reduced to less than 50, when feasible for the subject, with both historic and recent citations. We have again attempted to avoid duplication of a subject or conflicting opinion, recognizing that this is not always possible when we also ask that each author make original contributions.

For this edition, we are very excited about the inclusion of a Trauma Atlas of anatomic drawings and recognized surgical approaches. The three editors selected the drawings we believe best illustrate our current best practice for exposure and reconstruction. The descriptors with each drawing are short and succinct.

Finally, and most importantly, the authors acknowledge the assistance of many people who make it possible to successfully accomplish this major endeavor, edition after edition. We are grateful to the authors who have contributed their knowledge, experience, writing talent, and valuable time. The expertise of the support personnel at all levels at McGraw-Hill Publishers is essential and appreciated at each step for each edition. Each editor has office assistants who have performed many tasks, from interacting with authors to pushing the editors to meet deadlines. Mary Allen, in Kenneth Mattox's office, Jo Fields in E. Eugene (Gene) Moore's office, and Samantha Buckner in David Feliciano's office all worked diligently to support this project. As assistant to the senior editor of the Seventh Edition, Mary Allen was tireless in coordinating the work of editors and authors to bring this project to fruition. Mary was present at the very first concept formulation meeting, when Trauma was just a dream, and has been present at all editorial meetings since. Thank you, Mary, for your significant efforts in this and all previous editions of Trauma.

Kenneth L. Mattox, MD
Ernest E. Moore, MD
David V. Feliciano, MD

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