TITLE

Penetrating peripheral vascular injury management in a Sri Lankan military hospital

AUTHOR(S)
Ratnayake, A.; Samarasinghe, B.; Halpage, K.; Bala, M.
PUB. DATE
April 2013
SOURCE
European Journal of Trauma & Emergency Surgery;Apr2013, Vol. 39 Issue 2, p123
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: Vascular injuries in austere military conflict settings are a challenging problem. The goal of the current study was to analyze the unique features associated with the management and early outcome of penetrating vascular injuries resulting from the conflict in Sri Lanka. Methods: All adults with extremity vascular injuries admitted to the Military Base Hospital Anuradhapura in an eight-month period were prospectively recorded in a data sheet and retrospectively analyzed. Mechanism, location, method of repair, and outcomes were analyzed. Result: Out of a total of 5,821 combat-related casualties, there were 128 victims with vascular injuries (2.2 %). The overall limb salvage rate was 83 % with an all-cause mortality of 3.1 %. Combined arterial and venous injuries were most common (44 %), predominantly in the popliteal zone. Among the arterial injuries, 70 % were repaired with a vein interposition graft and 7 % were primarily repaired. The majority of the venous injuries (54 %) were ligated. Twenty early major complications were recorded. A temporary intraluminal shunting technique was applied in the 14 most severely injured patients. This patient population was followed up for an average of 35 days institutionally before they were referred to rehabilitation (60 %) or transferred to other institutions (26 %). Conclusions: Vascular reconstruction using vein, combined with a wound management strategy and early fasciotomy, resulted in a high limb salvage rate and remarkably low infection, delayed amputation, and mortality rates. Management of combat vascular injuries based on clinical guidance is feasible and leads to good outcome in a minimally equipped setting during local military conflicts. Surgeons in military hospitals should be trained in vascular injury repair to save the lives and functional limbs of patients.
ACCESSION #
86418943

 

Related Articles

  • The characteristics and outcomes of penetrating thoracic and abdominal trauma among children. Boleken, Mehmet; Cevik, Muazez; Yagiz, Beytullah; Ter, Mehmet; Dorterler, Mustafa; Aksoy, Tugrul // Pediatric Surgery International;Aug2013, Vol. 29 Issue 8, p795 

    Purpose: Trauma is the most important etiology of morbidity and mortality among children. Penetrating injuries to the thorax and abdomen are extremely rare in children. In the present study, we compared the characteristics of patients, management, and outcomes of penetrating thoracic and...

  • Vascular Injuries Caused by Tear Gas Shells: Surgical Challenge and Outcome. Wani, Mohd Lateef; Ahangar, Ab Gani; Lone, Gh Nabi; Singh, Shyam; Dar, Abdul Majeed; Bhat, Mohd Akbar; Ashraf, Hakeem Zubair; Irshad, Ifat // Iranian Journal of Medical Sciences;Mar2011, Vol. 36 Issue 1, p14 

    Background: Tear gas shells are used to disperse the mob during any type of street protests. Vascular injuries due to tear gas shells have not been reported. The present study was undertaken to analyse the pattern, presentation, management and outcome^of vascular injury due to tear gas shells....

  • Analysis of vascular injury in lumbar spine surgery. Yidong Liu // Pakistan Journal of Medical Sciences;Oct-Dec2012, Vol. 28 Issue 5, p791 

    Objective: To investigate the incidence of vascular injury in lumbar spine surgery and determine the strategy for its diagnosis and treatment. Methodology: We retrospectively reviewed 1159 patients in our institution treated with lumbar spine surgery from September 2003 to November 2009. Primary...

  • Penetrating carotid artery: uncommon complex and lethal injuries. Asensio, J.; Vu, T.; Mazzini, F.; Herrerias, F.; Pust, G.; Sciarretta, J.; Chandler, J.; Verde, J.; Menendez, P.; Sanchez, J.; Petrone, P.; Marini, C. // European Journal of Trauma & Emergency Surgery;Oct2011, Vol. 37 Issue 5, p429 

    Carotid arterial injuries are the most difficult and certainly the most immediately life-threatening injuries found in penetrating neck trauma. Their propensity to bleed actively and potentially occludes the airway and makes surgical intervention very challenging. Their potential for causing...

  • A Rare Case of Penetrating Rectal Injury. Thomas, Vijy // Indian Journal of Surgery;Jun2013, Vol. 75 Issue 3, p242 

    Penetrating injuries of the colon and rectum have been reported earlier and are often associated with injuries of adjacent viscera such as bladder, uterus or vagina, prostate and seminal vesicles as well as iliac vessels. But this case is rare not only regarding the mechanism of injury but also...

  • Penetrating anorectal injuries in Jamaican children. Vincent, Michelle; Abel, Colin; Duncan, Newton // Pediatric Surgery International;Nov2012, Vol. 28 Issue 11, p1101 

    Purpose: To discuss the presentation, management and outcomes of penetrating anorectal injuries at the Bustamante Hospital for Children. Methods: A retrospective review over an 11-year period (January 2001-December 2011) was undertaken. The data analysed were extracted from patients' case notes...

  • More summertime problems to treat. Brien, James H. // Infectious Diseases in Children;Aug2009, Vol. 22 Issue 8, p5 

    The article describes the treatment for a 6-year-old boy who sustained an injury to his left arm when a piece of coat hanger wire flew out from under a lawn mower, which produces a through-and-through penetrating wound just proximal to the elbow.

  • The impact of shorter prehospital transport times on outcomes in patients with abdominal vascular injuries. Ball, Chad G.; Williams, Brian H.; Tallah, Clarisse; Salomone, Jeffrey P.; Feliciano, David V. // Journal of Trauma Management & Outcomes;2013, Vol. 7 Issue 1, p1 

    Background Most deaths in patients with abdominal vascular injuries (ABVI) are caused by exsanguination and irreversible shock. Therefore, time to definitive hemorrhage control is an important factor affecting survival. The study goals were: (1) document current outcomes in patients with ABVI,...

  • A case of elbow hyperextension leading to complete brachial artery rupture. Jeyaretna, Deva S.; Butler, Michael; David, Huw G.; Walker, Alasdair J. // World Journal of Emergency Surgery;2007, Vol. 2, p6 

    Background: To our knowledge there are no cases in the literature of traumatic vascular injury of the brachial artery by elbow hyperextension without elbow dislocation based on either clinical or radiological evidence. Case presentation: We present the first case of complete brachial artery...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics