Management of Combat Related Vascular Injuries in a Zonal Hospital

Med J Armed Forces India. 2007 Jan;63(1):33-5. doi: 10.1016/S0377-1237(07)80104-3. Epub 2011 Jul 21.

Abstract

Background: The extremity gunshot wound (GSW) and penetrating splinter injuries from mine blast present a surgical challenge in the treatment of arterial trauma especially at non-vascular surgery centre. Adherence to specific principles of management is required for optimal limb salvage.

Methods: Fourteen vascular injuries in patients of GSW and mine explosions were managed at a zonal military hospital with successful outcome in two years. The diagnosis of arterial injury was done clinically.

Results: The commonest site of vascular injury was femoral. The methods of choice for repair were autogenous vein interposition or end-to-end anastomosis. All except for two patients retained a functional limb.

Conclusion: All surgeons in peripheral hospitals should be trained in vascular injury repair to save life and limb. Our series shows that right timing and prompt treatment of vascular injuries in a peripheral hospital, can give satisfactory results.

Keywords: Autogenous vein interposition; Fasciotomy; Gunshot wounds; Mine blast injuries; Vascular trauma.