Vascular Trauma Operative Experience is Inadequate in General Surgery Programs

Huan Yan, Steven Maximus, Matthew Koopman, Jessica Keeley, Brian Smith, Christian de Virgilio, Dennis Y. Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Vascular injuries may be challenging, particularly for surgeons who have not received formal vascular surgery fellowship training. Lack of experience and improper technique can result in significant complications. The objective of this study was to examine changes in resident experience with operative vascular trauma over time. Methods A retrospective review was performed using Accreditation Council for Graduate Medical Education (ACGME) case logs of general surgery residents graduating between 2004 and 2014 at 2 academic, university-affiliated institutions associated with level 1 trauma centers. The primary outcome was number of reported vascular trauma operations, stratified by year of graduation and institution. Results A total of 112 residents graduated in the study period with a median 7 (interquartile range 4.5–13.5) vascular trauma cases per resident. Fasciotomy and exposure and/or repair of peripheral vessels constituted the bulk of the operative volume. Linear regression showed no significant trend in cases with respect to year of graduation (P = 0.266). Residents from program A (n = 53) reported a significantly higher number of vascular trauma cases when compared with program B (n = 59): 12.0 vs. 5.0 cases, respectively (P < 0.001). Conclusions Level 1 trauma center verification does not guarantee sufficient exposure to vascular trauma. The operative exposure in program B is reflective of the national average of 4.0 cases per resident as reported by the ACGME, and this trend is unlikely to change in the near future. Fellowship training may be critical for surgeons who plan to work in a trauma setting, particularly in areas lacking vascular surgeons.

Original languageEnglish (US)
Pages (from-to)94-97
Number of pages4
JournalAnnals of Vascular Surgery
Volume33
DOIs
StatePublished - May 1 2016
Externally publishedYes

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Blood Vessels
Wounds and Injuries
Graduate Medical Education
Accreditation
Trauma Centers
Vascular System Injuries
Linear Models
Surgeons

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Vascular Trauma Operative Experience is Inadequate in General Surgery Programs. / Yan, Huan; Maximus, Steven; Koopman, Matthew; Keeley, Jessica; Smith, Brian; Virgilio, Christian de; Kim, Dennis Y.

In: Annals of Vascular Surgery, Vol. 33, 01.05.2016, p. 94-97.

Research output: Contribution to journalArticle

Yan, Huan ; Maximus, Steven ; Koopman, Matthew ; Keeley, Jessica ; Smith, Brian ; Virgilio, Christian de ; Kim, Dennis Y. / Vascular Trauma Operative Experience is Inadequate in General Surgery Programs. In: Annals of Vascular Surgery. 2016 ; Vol. 33. pp. 94-97.
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abstract = "Background Vascular injuries may be challenging, particularly for surgeons who have not received formal vascular surgery fellowship training. Lack of experience and improper technique can result in significant complications. The objective of this study was to examine changes in resident experience with operative vascular trauma over time. Methods A retrospective review was performed using Accreditation Council for Graduate Medical Education (ACGME) case logs of general surgery residents graduating between 2004 and 2014 at 2 academic, university-affiliated institutions associated with level 1 trauma centers. The primary outcome was number of reported vascular trauma operations, stratified by year of graduation and institution. Results A total of 112 residents graduated in the study period with a median 7 (interquartile range 4.5–13.5) vascular trauma cases per resident. Fasciotomy and exposure and/or repair of peripheral vessels constituted the bulk of the operative volume. Linear regression showed no significant trend in cases with respect to year of graduation (P = 0.266). Residents from program A (n = 53) reported a significantly higher number of vascular trauma cases when compared with program B (n = 59): 12.0 vs. 5.0 cases, respectively (P < 0.001). Conclusions Level 1 trauma center verification does not guarantee sufficient exposure to vascular trauma. The operative exposure in program B is reflective of the national average of 4.0 cases per resident as reported by the ACGME, and this trend is unlikely to change in the near future. Fellowship training may be critical for surgeons who plan to work in a trauma setting, particularly in areas lacking vascular surgeons.",
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