Management of vascular injury in counter insurgency area: A single-center study

Abstract

Background: Vascular trauma can threaten both limb as well as life of the patient. Combat-related vascular injuries are different from civilian vascular injuries in terms of epidemiology, mechanism, pathophysiology, and outcome. Combat or military trauma is generally penetrating trauma (high energy weapons). Difficult evacuation and transportation from the battle field complicates the vascular injury and its outcome. Materials and Methods: This is a single-center, prospective, observational study conducted at a service hospital in Jammu and Kashmir. Twenty-five patients with mean age 25.76 years (18–43 years) who underwent vascular intervention for trauma from December 2013 to November 2016 were included. Data pertaining to vascular injury regarding to site of injury, associated injuries, type of vascular repair, outcome, and complications were recorded and analyzed. Results: Five hundred and eighty trauma patients were admitted during the study period with 4.3% of the patients having vascular injury. All the patients were males and most of them were in the second or third decade of life. The mean time interval between the trauma and arrival to the hospital was 7 h. Lower extremity was the most common site of trauma (52%) of the patients followed by upper extremity. In 56% of the patients, vessels were repaired with reverse saphenous vein graft harvested from the uninjured limb. Two patients (8%) had secondary amputation and one patient (4%) died due to sepsis. Conclusion: Expeditious evacuation, quick transfer, early diagnosis and management including advanced endovascular care are essential for the limb salvage and survival of the serving soldiers.