Outcomes of Femoro-Popliteal Vascular Trauma Surgery: A Three-Year Survey (2011-2013) in Ahvaz Golestan Hospital (Iran)

Abstract

Popliteal artery injury is one of the peripheral vascular injuries, is a major cause of disability to maintain the damaged limb, and orthopedic injuries are its most common cause. This study aimed to investigate the effects of femoro-popliteal vascular injuries surgery and discover probable defects and weaknesses during the evaluation and treatment of patients to mitigate the effects of disability. This descriptive and analytical study retrospectively and prospectively evaluates the outcomes of femoro-popliteal vascular trauma surgery in fifty-four patients referred to Ahvaz Golestan Hospital during September 2011 to May 2013. The patients were evaluated for average time of ischemia, trauma mechanism, combined damages, vascular repair techniques, postoperative complications, recovery rate of fasciotomies, rate of recovery, and amputation rate. The data were analyzed using the independent t-test and Fisher's exact test and P<0.05 was considered as significant. The mean age of the 44 patients was 27.7 ± 12 years that 86.4% of them were men and 13.6% were female and 72.7% of patients were referred from the different counties of Khuzestan province to this center and the rest were from the provincial capital, Ahvaz. In 63.6% of patients, trauma mechanism was blunt and in the rest was penetrating. The most common combined injuries were bone fractures, and the most common vascular repair method was the saphenous vein interposition graft. Furthermore, 40.9% of victims underwent a fasciotomy that 72.2% were fully recovered. The average time of ischemia (from incident to reperfusion) was 26.1 ± 24.6 hrs. Although the majority of subjects (72.72%) was referred from the various cities of the province and caused to longer average time ischemia (from the accident until reperfusion), recovery rate after vascular repair surgery was 88.6%, and only five patients (11.4%) were amputated. Therefore, the long time average of ischemia (from the accident until reperfusion) alone cannot cause vascular remodeling or failure to perform an amputation. The multiple combined damages, including damage to the vein could have an important role in the amputation of a limb so that vein damage ratio did no show significant differences in two amputee and recovered groups (p = 0.008).