Muhammad Junaid Khan, Muhammad Asif Aziz, Anisa Shaukat.
Peripheral vascular trauma an experience of two years.
Pak Armed Forces Med J Jan ;57(2):125-8.

Background: The incidence of vascular trauma has increased considerably during last 40 years. The study was carried out to describe the causes of injury, presentations, surgical approaches, outcome and complication of vascular trauma of the upper and lower limbs. Shirty Design: This was a descriptive study. Setting: Surgical Department CMH Kharian, in which this study lasted from Oct 1997 to Oct 1999. Patients: In the study, 30 patients were operated for peripheral vascular injuries. Diagnosis was made by physical examination and hand Doppler alone. Primary vascular repair was carried out where possible; if not interposition vein graft was placed. Early liberal fasciotomy was considered as and when required. Patients with isolated venous trauma and patients with obviously unsalvageable lower extremity injury requiring primary amputation were excluded from the study. The limb salvage rate was 93.3%. Results: A total no of 30 patients were included in this study. Out of these 24(80%) were males and 6 (20%) were females, all were young adults with age ranging from 14 to 52 years, a mean age of 22 years and a standard deviation of. Gun short wound (GSW) constituted the major cause of trauma and was present in 18 (60%) Patients, road traffic accident (RTA) in 6 (20%) patients and stab wound in 6 (20%) patients which are comparable to international studies. Primary end-to-end anastomosis was done in 20 (66.07%) patients and graft interposition was done in 10 (33.3%) patients. Vein graft was used in 20 (66.07%) patients lateral repair was done in 7 (23.3%) patients while in 3 (10 %) patients ligation was performed. Early complications included bleeding in 2 (6.7%), thrombosis in 4 (13.3%) and wound infection in 3 (10%) patients respectively. Late complications are amputation in 2 (6.7%) patients and muscle ischaemia in 2 (6.7%) patients. Conclusion: Decisive management of peripheral vascular trauma will maximize patient survival and limb salvage. Priorities must be established in the management of associated injuries, and delay must be avoided when ischemic changes are present. Early fasciotomy is warranted if there is any suspicion of occurrence of compartment syndrome.

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