Management of small artery vascular trauma

Evaluation of Forearm Arterial Repairs: Functional Outcomes Related to Arterial Repair

“…[15] The literature indicates that most prominent factor in prognosis of arterial injury in the forearm is presence of accompanying nerve damage; ratio has been estimated to be as high as 58%. [1] Ratio was determined to be 85% in our series. As Douglas reports, Tsai found 87% of functional results ranged from adequate to excellent after ulnar nerve repair with concomitant patent ulnar artery repair, compared to 33% for thrombosed arterial repair.…”

“…[3] They also advocated ligation when it was felt arterial repair would jeopardize the patient's well-being. [3] Ballard et al [1] treated almost half of their patients with single forearm arterial injuries using ligation; they compared results with patients who underwent repair, and declared that both treatment modalities led to same outcome. In cases where both arteries are transected, at least the ulnar artery should be repaired; however, if the palmar arch is not intact, both arteries must be reconstructed.…”

“…Although functional recovery directly depends on severity of accompanying injuries, decreased arterial flow can also negatively affect wound healing and functional recovery. [1] Twenty years ago, occlusion after vessel repair was frequent, and ligature of arteries in patients who had well-perfused hand was reliable method. [1] However, present widespread use of surgical loupes and improvements in technical facilities have raised success rate of surgical repair by almost 100%.…”

“…[1] Twenty years ago, occlusion after vessel repair was frequent, and ligature of arteries in patients who had well-perfused hand was reliable method. [1] However, present widespread use of surgical loupes and improvements in technical facilities have raised success rate of surgical repair by almost 100%. [4] Although isolated vessel injuries of the forearm are a problem frequently encountered by plastic surgeons, long-term data in the literature concerning this type of injury are quite limited.…”

“…Stab wounds and injuries caused by broken glass constitute primary causes of this type of injury. [1] Arterial bleeding along axis of the wound, pulselessness distal to the injury, and positive Allen test are sufficient to diagnose problem. However, color Doppler ultrasonography (CDUS) can be used to confirm diagnosis.…”