Management of vascular trauma

Objective: To characterize the vascular injuries, their management and the results. Subjects and Methods: Cases of vascular injuries received at the hospital amongst the total of 3134 trauma patients were evaluated. Thirty six cases with 41 vascular lesions were evaluated, excluding the three primary amputations. Vascular injuries were then characterized by age, gender, site, mechanism, associated injuries, need and type of surgery. Results: Penetrating trauma accounted for 94.4% of all vascular admissions. Five percent of the vascular injuries developed complications. Surgical intervention was required in all cases (100%). Reverse saphenous vein graft was used in 82.9%. The injured veins were mostly ligated except one, which was managed by saphenous vein graft. The average time lapsed between injury and intervention of patients ranged between 2 to 18 hours. No mortality or secondary hemorrhage was documented. Conclusion: Vascular trauma represents a small percentage of all trauma admissions. It has a high morbidity and most require surgical intervention. The operative intervention rates are higher in patients with vascular injuries than in the general trauma population but with prompt surgery, the chances of limb salvage increases and the overall complication rate reduces. (author)