Ramírez-González AH, Cendejas-Molina JL, Luna MMR

Language: Spanish
References: 20
Page: 55-61
PDF size: 151.54 Kb.

ABSTRACT

Background: The most important data on vascular trauma have been obtained from war conflicts around the world. In the past few years vascular injuries on civil population have become increasingly complex, mostly due to high velocity projectile weapons.
Objective: To communicate personal experience on vascular trauma in the last 30 years. To analyze type of injuries, diagnosis criteria, preliminary treatment and treatment results.
Material and methods: Patients were sorted by date of injury, age and sex, and then grouped by decade. This resulted on two different groups: a) Injuries to major vessels and b) Injuries to minor vessels. Period of time on how each patient evolved was also considered. Each treatment was determined by injuries type and mechanism. When the injuries resulted on a destroyed limb the Mangled Extremity Severity Score (MESS) criteria was applied.
Results: From 1982 to 2012, 117 with vascular trauma were treated; 99 males and 19 females, ages ranging from 30 to 40 years. On 87 patients (74%) surgical procedures were conducted within the first 12 h from the injury. Major vessels injuries were present on 102 patients. Most of the injuries on these patients were treated by interpose a saphena vein segment and termino-terminal anastomosis. 14 amputations were conducted, 8 deaths and 81% rate 95 patients total were treated successfully.
Conclusions: Vascular traumas are a challenge to all surgeons due every time more severe and less frequent injuries. Hard data and ultra sound aid are enough evidence to suggest an exploring surgery on the patient. All conditions must be considered based on type of injury, on whether or not to attempt to repair an injury after a 12 h period. An evaluation method must be conducted on destroyed extremities cases, to determine whenever a preliminary amputation is needed. Prompt response and an adequate management of these injuries allow a high rate for successful procedures.

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