Extremity Vascular Trauma-the Continuing Challenge.

Abstract

A retrospective study of 36 consecutive patients with extremity vascular trauma managed by the South Surgical Ward trauma team between February 1998 to January 2000. All our patients were men with a mean age of 27 years. The commonest clinical presentation was with haemorrhage (75%) or ischemia (58.4%). The mode of injury was gunshot wounds (75%), blunt trauma (20%) and iatrogenic injuries (5%). The most commonly injured arteries were the superficial femoral (27.5%), the popliteal (24%) and the brachial (24%). The techniques utilized for repair of the arterial injuries were autogenous reverse vein grafting (51.7%), end-to-end anastomosis (27.6%) and lateral repair (3.4%). 17.2 % of the arterial injuries were ligated. 43 % of the venous injuries underwent lateral venorrhaphy while 57 % were ligated. Tri-compartment leg fasciotomies were carried out in 14 patients. The commonest complication was vein graft thrombosis (16.7%). Our amputation rate and mortality were both at 6.9%. Early transport of the patient to a good surgical facility, good surgical judgement and the liberal use of vein grafts improves the outcome in vascular injuries of the extremities.