The changing workload of a surgical unit with a vascular interest

Objectives: To examine the changing relationship between general and vascular surgical workload on a vascular “firm”, over a 6-year period. Design: Retrospective review. Setting: Leicester Royal Infirmary and Professorial Surgical Unit, U.K. 1987–1992. Method: Analysis of audit of all surgical admissions. Relation of vascular surgery to general surgery. Results: There has been a slight decrease (5%) in the number of general surgical elective admissions. Overall, the number of general surgical admissions, both elective and emergency, show a slight increase of about 3%. In contrast the number of vascular admissions increased by 42%. Of the general surgical procedures carried out 75.9% were either minor or intermediate, whereas 92.5% of vascular procedures were coded as major or higher. There has been a three times increase in the number of carotid endarterectomies, a similar increase in the number of the femorodistal bypass grafts and a halving of the number of major amputations. There has also been a five times increase in the number of angioplasties carried out. Conclusions: Our figures show the progressive, rapid increase in vascular surgical workload, compared to general surgery, and the need for the continued expansion of vascular surgery as a speciality.