Vascular injuries in the state of Pará, Brazil, 2011-2013 and their relation with demographic and clinical variables

Abstract

Background: Vascular traumas are associated with high morbidity rates. Objective: To report the characteristics of vascular traumas in the Brazilian state of Pará, in trauma victims treated at the Hospital Metropolitano de Urgência e Emergência (HMUE), from 2011 to 2013. Method: This was a descriptive, cross-sectional, retrospective and quantitative study that analyzed data on sex, age group, geographical origin, time waiting for care, mechanism of trauma, clinical status, anatomic site of injury, prevalence of associated fractures, vascular structures injured, types of vascular injury, principal types of surgery, early postoperative outcomes, level of amputation, number of deaths, length of hospital stay and multidisciplinary care for 264 medical records. Results: The majority of victims were male and the most common age group was from 16 to 30 years. The majority of cases were from towns other than the state capital, accounting for 169 cases (64.02%). The principal mechanism of injury was firearm wounding -110 (41.67%) followed by cold weapon wounds -65 (24.62%) and traffic accidents -42 (15.91%). The segments of the body and the vascular structures most often injured were lower limbs -120 (45.45%) and injuries to the popliteal and femoral arteries and veins. The most common clinical presentation at admission was hemorrhage -154 (58.33%). The most common surgeries were ligatures of veins and arteries. There were 163 (61.74%) hospital discharges and 33 (12.5%) deaths. Conclusions: The greatest prevalence observed was related to traumas caused by urban violence. Victims were most frequently male, of working age and from towns other than the capital of the state of Pará.

Surgical Management of Traumatic Arterial of Limbs in Antananarivo

“…Howether, other studies, particulary Shalabi's study [23], Joshi's study [8] and Singh's study [19], showed a high rate of venous bypass (saphenous vein graft interposition) with respectively 53%, 49% and 35.2%. According Wani's study, a venous bypass is indicated when the avulsion is greather than 2cm [24]. Primary amputation (5.43%) were indicated for an advanced ischemia, for a nonreconstructable arterial injury and when arterial injury associated for a complex fractures (severe soft tissue damage associated).…”

Prognostic factors in treatment of traumatic femoropopliteal arterial injuries at a Brazilian trauma center

“…National best-practice guidelines for pre-hospital or intra-hospital management of these injuries are not available and institutions with protocolized care are the exception. A few publications have described the management of vascular trauma and their outcomes in Brazil, [5][6][7][8][9] but no publications have specifically addressed management of femoropopliteal arterial trauma and its outcomes.…”