''Alternative'' surgery in the trauma discipline essentially means non
operative or a selective approach to the injured victim. Such an appro
ach is a critical part of the trauma management options. However, it i
s unlikely that the term ''alternative surgery'' will be liberally use
d to depict this growing trend of nonoperative, selective, and minimal
ly invasive trauma management because of its less than favorable conno
tations and biases with respect to alternative medicine. Although ther
e are still clear indications for emergency operative intervention, th
e nonoperative or selective approach in both penetrating and blunt tra
uma is the state of the art.