Pediatric vascular injuries: Are we preparing trainees appropriately to meet our needs?

- Comparison of surgical specialists managing pediatric vascular trauma over time.
- Increase in cases by vascular surgeons and decrease in cases by pediatric surgeons.
- Expansion of integrated residencies and early specialization training programs.
- Surgeons must receive training in both pediatric and vascular surgery.

BackgroundThere is no required competency for pediatric vascular injury in surgical training. We sought to describe changes over time for surgical specialists operating on pediatric vascular trauma injuries at a pediatric trauma center.MethodsCharts were retrospectively reviewed for vascular trauma injuries at a freestanding children's hospital between 1993 and 2015. Data were collected on mechanism, injured vessel(s), operation(s) performed, and specialists performing operation. Surgical specialists were compared over time.ResultsNinety-four patients (median age = 12) underwent 101 pediatric vascular trauma operations. There were significant differences in frequency of types of operations (primary repairs, graft repairs, and ligations) performed by pediatric, vascular, and orthopedic surgeons (P < .001). The proportion of operations performed by vascular surgeons increased and those performed by pediatric surgeons decreased significantly over time.ConclusionsVarious surgical specialists manage pediatric vascular trauma. With expansion of integrated residency programs, surgical specialists managing these patients in the future should be trained in both pediatric and vascular surgery.