DIFFICULT PERIPHERAL VASCULAR INJURIES - 11/09/11

Doi : 10.1016/S0039-6109(05)70484-9

Fred A. Weaver, MD, FACS ^a, George Papanicolaou, MD, FRCSC, Albert E. Yellin, MD, FACS

^a From the Division of Vascular Surgery, Department of Surgery, University of Southern California School of Medicine, Los Angeles, California

Resumen

Experience obtained from the major wars of the twentieth century provides the basis for the present approach to civilian peripheral vascular injuries.^{6 DeBakey E., Simeone C.F. Battle injuries of the arteries in World War II: An analysis of 2,471 cases Ann Surg 1946 ; 123 : 534 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 14 Gorman J.F. Combat arterial trauma analysis of 106 limb-threatening injuries Arch Surg 1969 ; 98 : 160

Haga clic aquí para ir a la sección de Referencias, 18 Hughes C.H. Arterial repair during the Korean War Ann Surg 1958 ; 147 : 555

Haga clic aquí para ir a la sección de Referencias, 23 Lovric Z., Wertheimer B., Candrlic K. , y al. War injuries of major extremity vessels J Trauma 1994 ; 36 : 248 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 35 Rich N.A., Baugh J.H., Hughes C.W. Acute arterial injuries in Vietnam: 1,000 cases J Trauma 1970 ; 5 : 359 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} Approximately 90% of all peripheral arterial injuries are located in the extremities, ^{35 Rich N.A., Baugh J.H., Hughes C.W. Acute arterial injuries in Vietnam: 1,000 cases J Trauma 1970 ; 5 : 359 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} with the lower extremity being more common in military experience and upper extremity vascular injuries more frequent in civilian experience. Wounds that involve vascular structures of the extremity are a significant cause of morbidity and mortality in the traumatized patient.

During World War II, ligation of the injured artery was routinely performed in extremity trauma. For popliteal artery injuries, ^{6 DeBakey E., Simeone C.F. Battle injuries of the arteries in World War II: An analysis of 2,471 cases Ann Surg 1946 ; 123 : 534 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} this resulted in an amputation rate of 73%. The formal repair of peripheral vascular injuries was first performed in the Korean conflict, ^{18 Hughes C.H. Arterial repair during the Korean War Ann Surg 1958 ; 147 : 555

Haga clic aquí para ir a la sección de Referencias} and these techniques were further refined during the Vietnam War, ^{35 Rich N.A., Baugh J.H., Hughes C.W. Acute arterial injuries in Vietnam: 1,000 cases J Trauma 1970 ; 5 : 359 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} during which the amputation rate for popliteal artery injuries declined to 32%. Continued improvement and refinements in the management of vascular injuries in the traumatized patient have reduced overall limb loss in civilian series to less than 5%. Severe long-term disability as a result of a vascular injury and associated injuries occurs in another 20% to 50%.^{49 Weaver F.A., Rosenthal R.E., Waterhouse G. , y al. Combined vascular and skeletal injuries of the lower extremities Am Surg 1984 ; 50 : 189

Haga clic aquí para ir a la sección de Referencias}