Extremity vascular trauma-the continuing challenge

ABSTRACT

A retrospective study of 36 consecutive patients with extremity vascular trauma managed by the South Surgical Ward trauma team between February 1998 to January 2000. All our patients were men with a mean age of 27 years. The commonest clinical presentation.was with haemorrhage [75%] or ischemia [58.4%]. The mode of injury was gunshot wounds [75%], blunt trauma [20%] and iatrogenic injuries [5%]. The most commonly injured arteries were the superficial femoral [27.5%], the popliteal [24%] and the brachial [24%]. The techniques utilized for.repair of the arterial injuries were autogenous reverse vein grafting [51.7%], end-to-end anastomosis [27.6%].and lateral repair [3.4%]. 17.2% of the arterial injuries were ligated. 43% of the venous injuries underwent lateral venorrhaphy while 57% were ligated. Tri-compartment leg fasciotomies were carried out in 14 patients The commonest complication was vein graft thrombosis [16.7%]. Our amputation rate and mortality were both at 6.9%. Early transport of the patient to a good surgical facility, good surgical judgement and the liberal use of. vein grafts improves the outcome in vascular injuries of the extremities