title: Pediatric vascular injuries: Are we preparing trainees appropriately to meet our needs?
abstract: BACKGROUND
  There 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.
  
  
  METHODS
  Charts 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.
  
  
  RESULTS
  Ninety-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.
  
  
  CONCLUSIONS
  Various 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.
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA. Electronic address: lgurien@gmail.com.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Gurien
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Maxson
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Melvin S
authors.initials: MS
authors.lastname: Dassinger
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Mehl
authors.affiliation: Department of Biostatistics, Arkansas Children's Hospital Research Institute, Little Rock, AR, USA.
authors.forename: Marie E
authors.initials: ME
authors.lastname: Saylors
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Samuel D
authors.initials: SD
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007396:Internship and Residency; D008297:Male; D010372:Pediatrics / Q000193:education*; D012189:Retrospective Studies; D013043:Specialties, Surgical / Q000193:education*; D014481:United States; D057772:Vascular System Injuries / Q000601:surgery*; D055815:Young Adult
keywords: Education; Injury; Pediatric; Training; Trauma; Vascular