Lower Extremity Vascular Trauma

Kumar, Neil G.; Knipp, Brian S.; Gillespie, David L.

doi:10.1016/b978-1-4557-1261-8.00015-1

Cited by 4 publications

(2 citation statements)

References 46 publications

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“…[28] Fasciotomy should be performed for compartment syndrome, delayed re-vascularization, major vein ligation, and at surgeon discretion. [30] When injuries were due to high-velocity firearms, close range shotguns, or crushing, careful inspection of the missile tract or the injury area was carried out, and tissues of questionable viability were debrided. Tracts created by stab wounds and low-velocity firearms-related injuries were not explored, and only limited skin debridement with primary closure was performed when required.…”

Section: Surgical Managementmentioning

confidence: 99%

Management Of Lower Limb Vascular Injuries in Ghazi Al Hariri Teaching Hospital/Baghdad 2015

Abdulhussein¹,

Adnan²,

Hamad³

2020

University of Thi-Qar Journal of Medicine

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Background: lower limb vascular injuries are encountered in a vast number of settings, ranging from blast, bullet , stab wounds injuries, to causes as small as blood sampling procedures. Surgery for vascular repair is sometimes indicated without angiography. Broadly speaking, options for repair after assessment of vasculature include simple vessel wall repair, venous patching, resection with end-to-end anastomosis or with inter-positioning graft, bypass graft, ligation or amputation.

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Section: Surgical Managementmentioning

confidence: 99%

Management Of Lower Limb Vascular Injuries in Ghazi Al Hariri Teaching Hospital/Baghdad 2015

Abdulhussein¹,

Adnan²,

Hamad³

2020

University of Thi-Qar Journal of Medicine

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“…While venous ligation is well accepted when the patient is unstable and has deranged physiology, simple venorrhaphy when it can be performed quickly and safely is acceptable and potentially keeps venous return intact. [3][4][5] After initial hemorrhage control, management of the venous injury is influenced by illness of the patient, severity of associated injuries, and complexity of the venous repair. Increased venous hypertension and compartment syndrome are possible consequences of venous outflow obstruction caused by vein ligation and may lead to higher rates of fasciotomy, wound infection, and limb loss.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Venous Thromboembolism and Eventual Amputation in Traumatic Femoral and Iliac Vein Injuries: A Trauma Quality Improvement Program Analysis

Falcon,

Caballero,

Filiberto

et al. 2024

The American Surgeon™

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Background Iliac and femoral venous injuries represent a challenging dilemma in trauma surgery with mixed results. Venous restoration of outflow (via repair or bypass) has been previously identified as having higher rates of VTE (venous thromboembolism) compared to ligation. We hypothesized that rates of VTE and eventual amputation were similar whether restoration of venous outflow vs ligation was performed at initial operation. Methods Patients in the 2019-2021 National Trauma Data Bank with iliac and femoral vein injuries were abstracted and analyzed. The primary outcomes of interest were in-hospital lower extremity amputation and VTE. Results A total of 2642 patients with operatively managed iliac and femoral vein injuries were identified VTE was found in 10.8% of patients. Multivariable logistic regression was performed and identified bowel injury, higher ISS, older age, open repair, and longer time to VTE prophylaxis initiation as independent predictors of VTE. Amputation was required in 4.2% of patients. Multivariable logistic regression identified arterial or nerve injury, femur or tibia fracture, venous ligation, percutaneous intervention, fasciotomy, bowel injury, and higher ISS as independent factors of amputation. Conclusion Venous restoration was not an independent predictor of VTE. Venous ligation on index operation was the only modifiable independent predictor of amputation identified on regression analysis.

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