IMPORTANCE OF DESIGNATED THORACIC TRAUMA SURGEONS IN THE MANAGEMENT OF TRAUMATIC AORTIC TRANSECTION

The medical literature is replete with reports on traumatic aortic tra nsection. These reports have delineated many factors regarding the mor bidity and high mortality of this ominous injury. Most reports are rev iews of the collective experience of a single institution over a perio d of years. It is likely that many authors writing on the subject of t raumatic aortic transection have no experience with operative repair o f the lesion. There has been debate about the various techniques of pr imary repair versus graft insertion, as well as the question of whethe r cardiopulmonary bypass is superior to the ''clamp and sew'' methods. No studies have directly examined the skills of individual surgeons w ith respect to outcome. We present the results of a study from a unive rsity-affiliated level I trauma center in which the outcomes from vari ous groups of surgeons were compared over a 5-year period. The informa tion in this study strongly suggests that designated thoracic trauma s urgeons who are promptly available and have dedicated interests in tra uma patients achieve better results.