# Enhancing surgical care for torture survivors: healing trauma, promoting recovery, and advancing best practices

## TL;DR

This paper reviews how to improve surgical care for torture survivors by using trauma-informed practices and interdisciplinary teamwork.

## Contribution

The paper emphasizes the need for trauma-informed surgical care and interdisciplinary collaboration for torture survivors.

## Key findings

- Torture survivors often face barriers to surgical care due to fear and mistrust.
- Surgical teams frequently lack the competence to manage torture-related injuries and psychological effects.
- Trauma-informed and interdisciplinary approaches are essential for effective care.

## Abstract

A significant proportion of refugees and asylum seekers have experienced torture, leading to complex, long-term physical and psychological health needs. Many require surgical care for trauma-related injuries but often face barriers such as fear, mistrust, and a lack of trauma-specific knowledge among healthcare professionals. In surgical settings, the absence of trauma-informed practices can contribute to retraumatisation, misdiagnosis, and inadequate care. This narrative review provides an overview offering clinical insights to underscore the importance of trauma-informed, interdisciplinary approaches in the surgical care of torture survivors.

This narrative review is based on a targeted literature search conducted across PubMed, Google Scholar, Scopus, and Web of Science between August 2023 and January 2024. Relevant articles were identified through keyword-based searches and manual reference screening. The review focused on literature addressing somatic and surgical care for torture survivors, with an emphasis on trauma-informed approaches. An iterative process was used until thematic saturation was achieved.

Torture survivors frequently suffer from chronic physical conditions—such as brain injuries, fractures, contractures, hearing loss, and genitourinary damage—that may require surgical intervention. Despite these needs, they often face significant barriers to care, including fear, mistrust, and a lack of trauma-specific competence among healthcare professionals. The literature highlights that many survivors receive conflicting diagnoses and inadequate treatment within surgical services, contributing to confusion and loss of trust. Surgical teams are often unprepared to identify signs of torture or manage their complex psychological and physical effects. A trauma-informed, interdisciplinary approach is essential to address these gaps.

Surgical care for torture survivors must integrate trauma-informed practices at all stages to ensure safety, dignity, and effective treatment. Interdisciplinary collaboration is essential. Further research is needed to evaluate these approaches and understand their long-term impact on surgical treatment outcomes.