Contemporary outcomes of civilian lower extremity arterial trauma

Liang, Nathan L.; Alarcon, Louis H.; Jeyabalan, Geetha; Avgerinos, Efthimios D.; Makaroun, Michel S.; Chaer, Rabih A.

doi:10.1016/j.jvs.2016.04.052

Cited by 66 publications

(58 citation statements)

References 13 publications

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“…Blunt peripheral vascular trauma is rarely encountered by the surgeons and can be particularly challenging in management due to atypical symptoms and often late presentation [ 5 , 6 ]. Due to improved understanding of injury mechanisms and expanded availability of management options, the outcomes of blunt vascular injury have improved in recent years [ 3 , 5 , 7 ]. Pathophysiologically, blunt trauma-induced arterial injuries frequently result in tunica intima tearing and following obstruction of the lumen by fresh thrombus [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Blunt vascular trauma in a patient with peripheral arterial disease: a case report and review of the literature

Karachentsev¹

2020

Journal of Surgical Case Reports

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Blunt vascular trauma is rare and challenging in management. Trauma victims who are elderly and have medical comorbidities are still uncommon, but their proportion is expected to increase, as life expectancy has been rising worldwide. A case of blunt vascular trauma to the lower extremity in a 70-year-old patient is reported. During the procedure, a contusion of the superficial femoral artery with thrombosis was identified. Besides, the artery was found to be affected by atherosclerosis. Thrombectomy with resection of the artery and end-to-end anastomosis was performed. Good early clinical outcome was achieved. Nonsystematic review of the available literature is also presented.

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Section: Discussionmentioning

confidence: 99%

Blunt vascular trauma in a patient with peripheral arterial disease: a case report and review of the literature

Karachentsev¹

2020

Journal of Surgical Case Reports

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“…The defects of cover tissues caused by mechanical factors differ regarding major anatomical and functional changes, damage to main vessels and nerves, bleeding, fractures of partial or complete separation of limb segments [5,6,7]. Injury is always accompanied by ischemia and infection of soft tissues and therefore it requires the fastest and most effective method of closing wound surfaces [2,3,4,9,14].…”

Section: Introductionmentioning

confidence: 99%

Reconstructive Surgery of Severe Damages of Lower Extremities Integument After Injury

Ponomarenko¹

2019

IJMMR

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Background. Injury of lower extremities requires the fastest and most effective method of closing wound surfaces. Objective. The aim of the study was to define the indications and improve the reconstructive interventions for severe damage of lower extremities integument due to mechanical trauma. Methods. During 2008-2016, 242 patients with defects of cover tissues of the body and extremities were operated in the clinic. Depending on the size, depth and degree of tissues damage, all were divided into 4 groups. Results. The lower extremity was the most vulnerable segment (75.2% of patients). Damage Control tactics was used in 83% of cases. To protect the functionally tense areas, free plastics by a split skin graft (the 1st group – 12.8%, the 2nd – 20.4%, the 3rd – 37%, the 4th – 8.9%) were used for closure of the defect. If the wound defect affected functionally significant structures up to 1% of the body surface, the complex flaps of local tissues, tissues close to the defect and anatomically distant areas (the 2nd group – 6%, the 3rd – 10.6%, the 4th – 4.3%) were used. If the defect was more than 1% of the body surface only functionally tense areas were closed with compound complexes of tissues. The rest of the skin was restored by means of autodermoplastics. We suggested and approved our specific protocol of treatment of such injury. Conclusions. Implementation of the suggested protocol of reconstructive interventions for closure of the defects of cover tissues of lower limbs allowed attaining a positive result in 98.8% of the interventions.

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“…En mayor medida se comprometen las extremidades inferiores (31 -36 %), seguidas de las extremidades superiores (18,4 -31 %), los vasos abdominales y pélvicos (15,6 -21 %), el cuello (10 -24,8 %) y el tórax (10 -13,8 %) 3,5,6 . Se han descrito la severidad y el mecanismo de las lesiones en relación con la necesidad de manejo quirúrgico, que varía entre 2 a 60 % de todas las lesiones vasculares 1,2 . Entre los procedimientos requeridos en la reparación de estas lesiones están las ligaduras vasculares, los reparos primarios y el baipás o la embolización selectiva; tales procedimientos generan complicaciones postquirúrgicas como trombosis o estenosis del reparo (3 %), infección del sitio operatorio con necesidad de reintervención (1,1 %), reintervención por alguna causa relacionada con el procedimiento inicial (7,7 %) y amputaciones (3,3 -29 %) 7,8 .…”

Section: Introductionunclassified

“…Entre los procedimientos requeridos en la reparación de estas lesiones están las ligaduras vasculares, los reparos primarios y el baipás o la embolización selectiva; tales procedimientos generan complicaciones postquirúrgicas como trombosis o estenosis del reparo (3 %), infección del sitio operatorio con necesidad de reintervención (1,1 %), reintervención por alguna causa relacionada con el procedimiento inicial (7,7 %) y amputaciones (3,3 -29 %) 7,8 . La mortalidad relacionada con estas lesiones es de aproximadamente un 2 -22,9 % 5,6,9 , valores que cambian de acuerdo con variables como la energía del mecanismo de la lesión, el tiempo de evolución a la atención, el sitio de la lesión, las lesiones asociadas, el tipo de reparo y las características operativas de la cirugía inicial, entre otras 2,10 ; se han relacionado además como influyentes en la aparición de complicaciones tras el reparo de las lesiones vasculares.…”

Section: Introductionunclassified

Caracterización de trauma arterial periférico en un hospital de tercer nivel

et al. 2018

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ResumenIntroducción. El trauma vascular es un evento de baja frecuencia, con alta carga de morbilidad y mortalidad, que afecta mayormente a hombres jóvenes y en muchas ocasiones requiere manejo quirúrgico. Se asocia con múltiples complicaciones, que van desde la reintervención quirúrgica, hasta la amputación de la extremidad, las cuales, a su vez, se ven influenciadas por variables relacionadas tanto con el trauma como con la atención hospitalaria. Objetivo. Caracterizar los pacientes mayores de 13 años con traumatismos arteriales periféricos en el Hospital Universitario Hernando Moncaleano Perdomo, de Neiva, Huila, Colombia, en el periodo enero de 2014 a diciembre de 2016. Materiales y métodos. Estudio observacional, retrospectivo, de tipo descriptivo, con población a conveniencia de pacientes mayores de 13 años que sufrieron traumatismos arteriales periféricos y fueron llevados a procedimiento quirúrgico en el Hospital Universitario Hernando Moncaleano Perdomo. Resultados. Se encontraron 54 pacientes con trauma arterial periférico, cifra que representa el 1,5 % de los ingresos por trauma en la Institución durante el período de estudio. El género más representativo fue el masculino (n=49), las heridas por arma cortopunzante el principal mecanismo de trauma (n=22) y las extremidades el área comúnmente afectada (n=47). Se halló un puntaje de gravedad de la lesión promedio al ingreso de 26 puntos, y un tiempo de isquemia de extremidad mayor a seis horas al momento del ingreso en el 31,5 % de los casos (n=17). Conclusiones. Las intervenciones quirúrgicas fueron hechas en mayor medida por cirugía de trauma, seguido de cirugía vascular. El principal manejo fue la anastomosis término-terminal y el injerto de safena invertida. Las complicaciones fueron en mayor medida la trombosis arterial (n=12), seguida de la amputación de extremidad (n=7). Palabras clave: lesiones del sistema vascular; heridas penetrantes; traumatismo múltiple; extremidad inferior; extremidad superior; procedimientos quirúrgicos vasculares.https://doi.org/10. 30944/20117582.72 273 Rev Colomb Cir. 2018;33:272-79 Trauma arterial periférico AbstractIntroduction. Vascular trauma is a low frequency event, with a high burden of morbidity and mortality that mostly affects young men. It often requires surgical management, which is associated with multiple complications ranging from reoperation to limb amputation; that in turn, are influenced by variables associated with both trauma and hospital care. Objective. To characterize the patients over 13 years of age with peripheral arterial trauma admitted to the Hernando Moncaleano Perdomo University Hospital, Neiva, Colombia, from January 2014 to December 2016. Methods. Retrospective observational study of descriptive type with population of patients older than 13 years with peripheral arterial trauma who had a surgical procedure at the Hernando Moncaleano Perdomo University Hospital.Results. This study showed that the 54 patients with peripheral arterial trauma represented 1.5% of the total trauma admissi...

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Contemporary outcomes of civilian lower extremity arterial trauma

Cited by 66 publications

References 13 publications

Blunt vascular trauma in a patient with peripheral arterial disease: a case report and review of the literature

Blunt vascular trauma in a patient with peripheral arterial disease: a case report and review of the literature

Reconstructive Surgery of Severe Damages of Lower Extremities Integument After Injury

Caracterización de trauma arterial periférico en un hospital de tercer nivel

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