Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=27365688
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Management of Vascular Injuries in a Forward Hospital
#MMPMID27365688
Rai KM
; Mohanty SK
; Kale R
; Chakrabarty A
; Prasad D
Med J Armed Forces India
2006[Jul]; 62
(3
): 246-51
PMID27365688
show ga
BACKGROUND: Management of vascular injuries poses a challenging problem under
warlike conditions. Several authorities recommend limb revascularisation only
within first 6-8 hours, as the outcome after delayed revascularisation is poor.
METHODS: A retrospective analysis of 61 consecutive patients with vascular injury
in a forward hospital over a 25- month period was carried out. RESULTS: Vascular
injuries constituted 3.1% of all injuries. The mean injury to treatment delay
(lag time) was 11 hours, and 10 patients received treatment after 12 hours. The
overall amputation rate was 15%, but only 6.5% for those revascularised within 12
hours and 44% for those undergoing surgery after 12 hours (Chi-square 4.59, p <
0.05). Presence of associated fractures was associated with an adverse outcome
(Chi-square 4.24, p < 0.05), as was ligation in comparison to revascularisation
(Chi-square 7.86, p < 0.005). Popliteal injuries were associated with a high
amputation rate. CONCLUSIONS: Failure to revascularise (ligation of artery),
presence of associated fracture, and restoration of circulation beyond 12 hours
are associated with a high amputation rate.
free
free
free
