Mumtaz Ahmad Khan, Tanwir Khaliq.
Peripheral vascular trauma and its management.
Ann Pak Inst Med Sci Jan ;1(2):58-61.

History of trauma is as old as the history of mankind and first recorded incidence of trauma is the conflict of Kane and Abel. The world has seen a tremendous rise in the incidence of trauma recently because of the social factors and easier availability of assault weapons. Vascular trauma has seen the same upward trend. During the world wars I & II, ligation of the bleeding vessels was the only solution to save the life of the soldiers in extremity trauma and it was followed by 30% amputation rate. Later In Korean and Vietnamese conflicts the same dismal prognosis was reported however over the next few decades methods of asepsis improved, better suture materials were available and surgical techniques were further refined so amputation rate decreased proportionately especially due to increasing understanding of the revisualization techniques. Today an amputation rate of 5% is considered a standard. However amputation rate observed in our set up is still very high, just close to the rate observed with ligature of the vessels. It has been observed that most of these patients present very late after the injury. Various studies have been performed in literature to identify the factors responsible for late presentation, a major cause of poor outcome. Time is the critical factor in the final outcome of the patient with vascular repair. Vascular Repair performed within 6 hours results in near normal return of function while delay of 12 hours or more leads to unacceptable high rate of morbidity in terms of Amputation.

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