Arterial injuries in civilian practice

ABSTRACT

This study deals with the experience met with in the management of 115 cases of arterial injuries in civilian practice. A high incidence of iatrogenic injuries was noted [42.6%], due to the increased use of arterial cathetirisation for diagnostic purposes. Diagnosis of these cases proceeded mainly on clinical grounds. Arteriography was reserved for doubtful cases [exclusion arteriograms], or when there was a need for localisation of the site of the injury. Success in the management of these cases was attributed in the first place to the wide use of autogenous vein grafts [57.3%] as opposed to end to end anastomoses or synthetic vascular grafts. In addition to this, was the proper coverage of the vascular grafts by the use of myocutaneous flaps, doing an adjunctive fasciotomy when needed, as well as the proper evaluation and management of associated venous [8.7%], orthopedic [13.04%] and nerve [4.3%] injuries. The amputation rate, as well as the mortality rate in this series [5.2% and 2.6%, respectively], were low