Abstract
The vascular surgeon is trained in the management of diseases affecting all parts of the vascular system except that of the heart and brain whereas cardiothoracic surgeons manage surgical diseases of the heart and its vessels. Although vascular surgery is previously a field within general surgery, it is now considered a specialty on its own right in many countries such as the UK and the United States. Other countries such as Iraq have a mixed practice in which the cardiac or thoracic surgeon performs vascular surgery. Programs of training in vascular surgery are slightly different depending on the region of the world one is in. In the United States, a 5-year general surgery residency is followed by 2 years training in vascular surgery. In Iraq, the time table allocated for the general surgical trainee in vascular surgery is unfortunately short (1 - 3 months). This period is hardly enough for the candidate to grasp the decision-making and technical skills of vascular surgery. We believe that general surgeons need to have adequate training and expertise in vascular surgery particularly in areas and situations lacking this facility to deal with the life- and/or limb-threatening emergencies. This review article aims to orient the general surgical trainee about the scope of vascular surgery and enable them to correctly diagnose and treat common vascular emergencies such as extremity and abdominal vascular injuries (AVI).
Highlights
Vascular surgery is a well established subspecialty for many decades. It was previously considered a field within general surgery, vascular surgery is considered a specialty in its own right [1]
In Iraq, vascular surgeons deal with a wide spectrum of emergent and elective conditions such as vascular trauma in different parts of the body, thromboembolectomy, vascular access for hemodialysis, peripheral arterial disease, varicose veins, abdominal aortic occlusion and aneurysm, carotid endarterectomy, dorsal and lumbar sympathectomy and others
The outcome of vascular repair in extremity vascular trauma is measured by limb salvage rate
Summary
Vascular surgery is a well established subspecialty for many decades. it was previously considered a field within general surgery, vascular surgery is considered a specialty in its own right [1]. UK for example, vascular surgery is practiced separately from general, thoracic and cardiac surgery [3]. Before the emergence of cardiothoracic surgery in Iraq, vascular surgery was practiced by other surgeons mainly general and sometimes orthopedic surgeons. In Iraq, most of the cardiothoracic and vascular surgeons are graduates of the Iraqi Board for Medical Specializations (IBMS) that was established in 1988 whereas minority has a high Diploma in thoracic and vascular surgery. In 2008, the ratio of active thoracic surgeons per 100,000 Iraqi populations was 0.47; much lower than the American ratio of 1.36 This calculated ratio is based on all the graduates and does not take into consideration the number of surgeons who were either killed or left the country for one reason or another. The general as well as the orthopedic surgeon need to have an adequate training and a good expertise in vascular surgery in areas and situations lacking the facility of proper vascular surgery to deal with emergency cases of vascular trauma in the extremities and/or the abdomen to save the life and limbs of patients [4]
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