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Demographics, treatment, and early outcomes in penetrating vascular combat trauma Sohn VY; Arthurs ZM; Herbert GS; Beekley AC; Sebesta JAArch Surg 2008[Aug]; 143 (8): 783-7OBJECTIVES: To describe arterial and venous injuries and their management and short-term outcomes in a wartime hospital. DESIGN: Retrospective review of patients with vascular injuries. Mechanism, location, method of repair, and outcomes were analyzed with descriptive and inferential statistics. SETTING: The 31st Combat Support Hospital, Operation Iraqi Freedom. PATIENTS: A total of 153 patients with 218 vascular injuries from January 1, 2004, to December 30, 2004. MAIN OUTCOME MEASURES: Limb salvage and mortality rates. RESULTS: The overall limb salvage rate was 80%, while all-cause mortality was 6%. Most vascular injuries were sustained by blast and fragmentation mechanisms. Not surprisingly, most vascular injuries were in lower extremity vessels (57% arterial, 50% venous), with a high predominance of superficial femoral vessel injuries. Vascular injuries to the upper extremities were associated with a higher limb salvage rate (95%) than injuries to the lower extremities (71%). Variable follow-up data for 63 (41%) patients revealed that 32 underwent further procedures outside the combat theater, 12 of which were delayed amputations. Of all arterial injuries, 36% were primarily repaired, 34% were repaired with a vein interposition graft, 29% were ligated, and 2% were repaired with a prosthetic graft. A majority of venous injuries (56%) were ligated. CONCLUSIONS: There is an acceptable early patency and limb salvage rate in combat vascular repairs. A majority of penetrating vascular injuries occur in the lower extremities. Overall, penetrating vascular trauma is often a survivable injury.|*Iraq War, 2003-2011[MESH]|Adult[MESH]|Blood Vessels/*injuries[MESH]|Female[MESH]|Hospitals, Military/statistics & numerical data[MESH]|Humans[MESH]|Limb Salvage[MESH]|Male[MESH]|Retrospective Studies[MESH]|Vascular Surgical Procedures/*statistics & numerical data[MESH]|Wounds, Penetrating/*epidemiology/*surgery[MESH] |
