Vascular injuries in basrah, iraq : a 5-year experience

الملخص EN

Objectives: To evaluate our results in the management of vascular injuries in comparison with other studies, to delineate the causes for failure in management, and to draw conclusions about the optimum management strategy for vascular trauma patients.

''patients ani Methods: Over a 5 year period from July 1995 to July 2000, 67 patients, 59 males and 8 females, were admitted to the Thoracic and Cardiovascular Surgery Department in the Teaching Hospital in Basrah with vascular injuries.

The age, sex distribution, etiology, anatomical location, type of injury, method of repair, and results were recorded.

Result: Fifty eight patients (86.5%) had vascular trauma in the extremity, 26 in the upper and 32 in the lower limb.

The most common cause of injury was bullet wounds (24).

The most frequently injured artery was the superficial femoral in the lower limb (14) and the brachial in the upper limb (12).

The most common type of arterial injury was transection (30).

Vascular injuries of the extremity were associated with fracture and/or dislocation in 21.7% in the upper limb and 43.7% in the lower limb.

More than half of arterial injuries (30 patients, 52.6%) were repaired by end-to-end anastomoses while the majority of injured veins were ligated (14 patients, 73.6%).

Six patients who presented with irreversible ischemia had primary amputations.

Five patients had secondary amputations (following a vascular repair).

Thus, the limb salvage rate was 94.6%.

There were 4 deaths; the mortality rate was 5.9%.

Conclusion: A good limb salvage rate was obtained in the study compared to other figures reported in the literature.

There is a need to emphasize the importance of clinical awareness among doctors for early recognition and prompt referral of the suspected cases.

Good surgical technique is essential.

Orthopedic as well as general surgeons should have adequate training in vascular surgery so that they can manage patients with vascular trauma when no vascular surgeon is present.