Major trauma provokes an overwhelming inflammatory and haemorrhagic response that challenges both patients and the systems designed to care for them. This session explores the science of trauma inflammation and its translation into surgical practice, while also examining the toll trauma takes on surgeons and services themselves. Presentations will cover the biology of trauma-induced immune dysfunction, advances in translational research that are reshaping resuscitation and operative strategies, and the practical application of coagulation science to modern haemorrhage control. The session also considers how teams and systems behave under pressure — with lessons drawn from both biology and clinical experience — and concludes with a panel discussion on integrating scientific discovery, clinical practice, and surgeon wellbeing. Designed to bridge laboratory insights, operative decision-making, and the human factors of trauma surgery, this program will appeal to scientists, academic surgeons, and practising clinicians alike.