Operative management of non-iatrogenic pediatric and adolescence peripheral arterial trauma: An experience from a resource challenged setting

Reliability of the Mangled Extremity Severity Score in the Management of Peripheral Vascular Injuries in Children: A Retrospective Review

“…35 It has been postulated that following limb revascularization, prompt fasciotomy was accompanied by a four-fold decrease in both the rate of amputation and other relevant complications. 35,36 In our series, the amputation rate is much common in older children, as it was performed in patients above the age of 15 years. These results are similar to that reported in the literature.…”

“…1,20,[23][24][25][26]30,31 The summary of our results in comparison to that reported in some literature reports are represented in (►Table 6). 1,20,[22][23][24][25][26]30,31,35 Despite acceptable vascular patency rate; a long-term functional outcome was developed in 23% of our treated patients during the 24month follow-up period. This functional disability may be considered as the most important and vexing aspect of pediatric vascular injuries.…”

Current Opinions in Open and Endovascular Treatment of Major Arterial Injuries in Pediatric Patient

“…These patients have been considered at high risk for the development of complications [17]. Although the preservation of functional status after revascularization appears satisfactory from our review, with very few arterial reinterventions having been reported, follow-up compliance was meager; the established body of literature for trauma with true long-term follow-up is scant [1,3,5,8,18,26]. Therefore, the true incidence of reintervention may be underestimated, and follow-up protocol mandates robust refinement especially because pediatric patients have their whole lives ahead of them to be exposed to problems related to the index intervention.…”

“…Due to the complexity of vascular trauma, many patients must be treated in vascular surgical centers initially not intended for pediatric care [6,7,18,19]. While the principles of arterial reconstruction and revascularization are the same in both pediatric and adult patients, there are renown essentials during open surgical repair that are worth mentioning in pediatric patients [1,7,8,14,15,17]. First, we should remember that arterial reconstruction needs more than just patency-preserving flow to adequately support vessel growth.…”

“…First, there is not a commonly accepted threshold to define a pediatric vascular injury, but according to most of the published literature, it should be defined as a vascular injury occurring in patients between 2 and 16 years of age [2]. Second, the true incidence is still matter of debate, since most reported experiences primarily concerned upper and lower extremity injuries, while lesions of the supra-aortic trunks or of the torso (e.g., thorax and abdomen) were rarely included [3][4][5][6][7][8][9][10]. Last, open surgery has been the mainstay of treatment, but no clear guidelines have been developed to recommend the best practice patterns in terms of strategy or repair as well as postoperative pharmacological regimen.…”