Status of trauma and acute care surgery in the United States.

Acute Care Surgery (ACS) is an evolving specialty. The components, as defined by the American Association for the Surgery of Trauma are trauma, surgical critical care and emergency surgery. As documented by the recent reports from the Institute of Medicine, the shortage of surgical specialists who make themselves available for emergency care in the United States, the overcrowding of emergency departments and lack of surge capacity are reaching crisis conditions. The Institute of Medicine has recommended the development of regional centers of surgical specialists, analogous to trauma systems. The training of surgeons in ACS will address the manpower issue to some degree.