Gefäßverletzungen nach Extremitätentrauma

Ockert, S.; Winkler, Michael; Richter, A; Palma, Pablo; Post, Sean M.

doi:10.1055/s-2002-33575

Cited by 7 publications

(2 citation statements)

References 5 publications

(5 reference statements)

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“…Meanwhile, vascular injuries of the upper extremities involved the brachial artery in 52% and the radial or cubital artery in 30% 6,7 . These results did not vary much from those reported previously in North America, Europe or Latin-America [8][9][10][11][12] . Complete or partial transection of the vessel was the predominant type of injury 12 .…”

Section: Epidemiologysupporting

confidence: 68%

Damage control of peripheral vascular trauma - Don’t be afraid of axillary or popliteal fosses

Herrera

Millán

Valle³

et al. 2021

Colomb Med

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Peripheral vascular injuries are uncommon in civilian trauma but can threaten the patient’s life or the viability of the limb. The definitive control of the vascular injury represents a surgical challenge, especially if the patient is hemodynamically unstable. This article proposes the management of peripheral vascular trauma following damage control surgery principles. It is essential to rapidly identify vascular injury signs and perform temporary bleeding control maneuvers. The surgical approaches according to the anatomical injured region should be selected. We propose two novel approaches to access the axillary and popliteal zones. The priority should be to reestablish limb perfusion via primary repair or damage control techniques (vascular shunt or endovascular approach). Major vascular surgeries should be managed postoperatively in the intensive care unit, which will allow correction of physiological derangement and identification of those developing compartmental syndrome. All permanent or temporary vascular procedures should be followed by a definitive repair within the first 8 hours. An early diagnosis and opportune intervention are fundamental to preserve the function and perfusion of the extremity.

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Section: Epidemiologysupporting

confidence: 68%

Damage control of peripheral vascular trauma - Don’t be afraid of axillary or popliteal fosses

Herrera

Millán

Valle³

et al. 2021

Colomb Med

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“…Amputation rate is variable in different studies. In some reports, rate of amputation was as low as 2.6% and in others it was as high as 56% ( 18 - 20 ). Delayed vascular reconstruction and severe musculoskeletal injuries were the most important prognostic factors in vascular injuries in extremities.…”

Section: Discussionmentioning

confidence: 96%

Assessment of Vascular Injuries and Reconstruction

et al. 2015

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Background:Trauma is the third leading cause of death. In this regard, vascular injury plays a leading role in of morbidity and mortality rates.Objectives:The present study aimed to assess the prevalence of vascular injuries and results of vascular reconstruction at a referral hospital in northern Iran.Patients and Methods:A retrospective observational study assessed 88 consecutive patients with vascular injury admitted to Poursina Hospital, Rasht in northern Iran, from October 2007 to October 2009. All study information was collected retrospectively from hospital charts.Results:Most of the affected patients (87/88) were male with a mean age of 29.12 ± 11.20 years. The mechanism of injury in 39.8% was blunt trauma and penetrating trauma in the rest. Of the 53 injured by penetrating trauma (60.2%), the most common cause was stabbing (94.3%). The most common cause of blunt trauma was road traffic accidents (93.1%). The most common mechanism for vascular injuries in upper extremities was penetrating trauma (86.0%) and in lower extremities was blunt trauma (60.0%). Fasciotomy was performed in 16 patients (18.2%) mostly in the lower extremities. Major amputation was required in 10% of the patients. In upper extremities, the most common type of revascularization was end to end anastomosis, followed by inter-position graft. The most common type of reconstruction in the lower extremity was bypass graft. All patients who underwent major amputation were admitted to the center with a delay of more than 6 hours after injury.Conclusions:Major vascular injuries in our center occurred in young men, frequently because of stab wounds. Popliteal injuries mostly caused by motor vehicle accidents was the second most common arterial injury, followed by combined ulnar and radial injuries. Vascular reconstruction in the first hours after trauma may prevent many unnecessary and preventable amputation procedures.

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