Operative Techniques in Vascular Injuries of Extremities
Arterial trauma of the limbs represents about 0.5% of all civilian trauma. Blunt trauma is the most frequent mechanism in civilian records, although penetrating trauma, especially gunshot wounds, is increasing. While over 95% of isolated injuries from penetrating trauma is successfully treated, blunt trauma lesions, particularly associated with musculoskeletal injuries, lead to a very high amputation rate, in some records over 50%. Despite progress in pathophysiology and surgical techniques, there are still different controversies in diagnosis and treatment of these patients. Unfortunately, due to the emergency treatment and lack of centers with sufficient numbers of cases, it is not generally possible to make control studies with level 1 or 2 evidence.
Therefore the majority of clinical studies are retrospective and case reports, cohort studies, or series of single centers, often limited in numbers.
Feliciano DV, et al. Evaluation and management of peripheral vascular injury: part I. Western Trauma Association/Critical decisions in trauma. J Trauma. 2011;70:1551–6.CrossRefGoogle Scholar
Feliciano DV, et al. Western Trauma Association critical decisions in trauma: evaluation and management of peripheral vascular injury: part II. J Trauma Acute Care Surg. 2013;75:391–7.CrossRefGoogle Scholar
Fox N, et al. Evaluation and management of penetrating lower extremity arterial trauma: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S315–20.CrossRefGoogle Scholar
Percival TJ, et al. Reperfusion strategies in the management of extremity vascular injury with ischaemia. Br J Surg. 2012;99(Suppl 1):66–74.CrossRefGoogle Scholar
Perkins ZB, et al. Meta-analysis of prognostic factors for amputation following surgical repair of lower extremity vascular trauma. Br J Surg. 2015;102(5):436–50.CrossRefGoogle Scholar
Wahlgren CM, et al. Penetrating vascular trauma of the upper and lower limbs. Curr Trauma Rep. 2016;2:11–20.CrossRefGoogle Scholar
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