Demographics, treatment, and early outcomes in penetrating vascular combat trauma

Archives of Surgery
Vance Y SohnJames A Sebesta

Abstract

To describe arterial and venous injuries and their management and short-term outcomes in a wartime hospital. Retrospective review of patients with vascular injuries. Mechanism, location, method of repair, and outcomes were analyzed with descriptive and inferential statistics. The 31st Combat Support Hospital, Operation Iraqi Freedom. A total of 153 patients with 218 vascular injuries from January 1, 2004, to December 30, 2004. Limb salvage and mortality rates. The overall limb salvage rate was 80%, while all-cause mortality was 6%. Most vascular injuries were sustained by blast and fragmentation mechanisms. Not surprisingly, most vascular injuries were in lower extremity vessels (57% arterial, 50% venous), with a high predominance of superficial femoral vessel injuries. Vascular injuries to the upper extremities were associated with a higher limb salvage rate (95%) than injuries to the lower extremities (71%). Variable follow-up data for 63 (41%) patients revealed that 32 underwent further procedures outside the combat theater, 12 of which were delayed amputations. Of all arterial injuries, 36% were primarily repaired, 34% were repaired with a vein interposition graft, 29% were ligated, and 2% were repaired with a prosthetic gr...Continue Reading

Citations

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