Management of vascular injuries during war in Jazan (Saudi Arabia): epidemiology and tips for vascular surgeons deploying to wars

Abstract

Background Extremity vascular injuries represent 50–70% of all injuries treated during wars. Hence, our objectives are to elaborate the challenges of vascular war injuries and to clarify their mechanisms, pattern, effectiveness of management and outcomes during war in Jazan. Patients and methods This is a descriptive study of patients with war-related vascular injuries treated in King Fahd Teaching Hospital during the war in Jazan (Saudi Arabia) from February 2016 to May 2016. The study included age, mechanism of injury, site of vascular injury, pattern of repair, and clinical outcome. Results This study included 56 patients with a mean age of 37 years. All patients were men (100%); four (7.1%) patients were civilians; 23 (41%) patients presented with blast injuries; and 33 (59%) patients presented with gunshot injuries. There were 40 (71.4%) arterial injuries, 16 (28.6%) venous injuries, and seven combined injuries (arterial and venous). Repair was done in 37 patients and ligation in 19 patients. Primary amputation was done in eight patients and secondary amputation in one patient. Conclusion Management of vascular injuries during wars presents a unique challenge to surgeons; standard vascular technical repair remains the gold standard management in vitally stable patients; primary extremity amputation is a lifesaving procedure in unstable patients with other life-threatening injuries.