Evaluation of peripheral vascular injuries treated with surgery: A retrospective cohort study

Abstract

Aim: Vascular injuries constitute 2-3% of the total injuries. Early diagnosis and emergent management of peripheral vascular injuries, which have high mortality and morbidity rates if inadequately managed, are particularly important. In this study, we aimed to evaluate the etiology and treatment results of patients who underwent surgical treatment due to peripheral vascular injury. Methods: This research was designed as a retrospective cohort study. The etiologies, localizations, accompanying injuries, surgical methods, and results of 57 cases operated due to peripheral arterial injury in Yozgat State Hospital and Bozok University Research Hospital between 2012 and 2019 were evaluated. Results: Fifty-two patients were male (91.23%) while 5 were female (8.77%). The mean age of all patients was 27.6 (10.5) years (range: 4 - 63 years). Among etiologies, injury due to sharp objects and firearms were significantly higher (n=34 (59.6%) and n=16 (28%), respectively). Traffic accidents were the cause in 5 (8.7%) cases and occupational accidents had occurred in 2 (3.5%) patients. Arterial injuries were detected in 33 (56.89%) upper extremities and 24 (41.87%) lower extremities. End-to-end anastomoses were performed in 29 cases, lateral arteriorrhaphy (primary repair) was performed in 24, autogenous saphenous vein interposition in 4 and ligation was performed in one patient. No cases required fasciotomy or amputation and one patient with a multi-trauma died. A secondary operation was needed for hematoma, thrombectomy, and anastomosis revision in seven, five and three cases, respectively. Conclusion: In vascular injuries, after ensuring hemodynamic stability, the primary aim is providing the accurate operation approach in the shortest time to reduce morbidity and mortality.