出版社：International Medical Journal Management and Indexing System
摘要：Objectives: Trauma has emerged as a major public health problem in developing as well as developed countries, and vascular trauma is an important component of this problem. The objective of the study was to analyze the causes of injury, surgical approaches, outcome, and complications with extremity vascular trauma at a tertiary level referral centre in North India. Materials and Methods: A retrospective analyses of 3948 patients operated for peripheral vascular injuries between November 2003 and November 2013 was done . Diagnosis was made by physical examination and hand held Doppler alone or in combination with CT angiography. Primary vascular repair was carried out where possible; if not possible the interposition vein graft was placed. Patients with isolated venous trauma and patients with obviously unsalvageable lower extremity injury requiring primary amputation were excluded from the study. Results: Of 3948 patients, 3347 were males (84.78%) and 601 of them were females (15.22%), and their ages ranged from 5-80 years. Mean duration of presentation was eleven hours after the injury. The most common etiological reason was road traffic accidents; 67% in penetrating trauma group and 58% amongst all blunt traumas. Incidence of concomitant orthopedic injuries was very 73.6%. The most common injured artery was brachial artery (36.4%), followed by popliteal artery (30.4%) and femoral artery (21.7%).Surgical procedures performed were primary repair in 58.3%, whereas interposition vein grafts were placed in 41.4% cases. Of all, 78% had viable and functional limbs and 13% had viable but non-functional limbs and rate of amputation after repair was 9%. Conclusions: Early diagnosis and treatment during vascular injuries has a prognostic value for saving the extremity and life of the patient. Vascular injuries require immediate surgical intervention, regardless of localization. Patients who suffer vascular injuries to the extremities should be transferred to vascular surgery centers as soon as possible. Priorities must be established in the management of associated injuries, and delayed repair must be avoided when ischemic changes are present.
关键词：Vascular system injuries; vascular surgical procedures; wounds and injuries
