Salman Yousaf Guraya, Javed Raza Gardezi, Ghulam Akbar Sial, Usman Malik, Ahsan Nasim, Ali Imran.
Peripheral vascular injuries - Jinnah Hospital Lahore experience.
Pak Postgrad Med J Jan ;11(3):99-102.

The incidence of vascular injuries of the extremities is scaling new heights in Pakistan. A total of 26 patients with acute peripheral vascular injuries were managed at the Department of Surgery, Jinnah Hospital, Lahore from May 1998 to May, 2000. All patients were male with a mean age of 29 years. Acute vascular injuries were caused by firearms in 76.9% of cases and by blunt trauma in 11.5%. Arterial bleeding from the wound was the commonest presentation (53.8%) followed by absent distal pulses (50%). 84.6% patients had arterial injuries, 15.3% isolated venous and 5 cases had associated venous lesions. Axillary artery was the most frequent vessel injured in 23% of cases. Autogenous sephenous vein graft was interposed in 13 (59%) patients, 7 (31.8%) had end-to-end and 2 (9%) had lateral repair of the injured artery. 191% developed post-operative wound infection, 11.5% fasciotomy wound infection and 153% developed distal limb edema. Amputation and mortality rate was 3.8% each. Statistical evidence for the prompt surgical intervention, more frequent use of interposition graft and low threshold for fasciotomy gave better results. Time is the key factor in determining the final outcome of vascular surgery.

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