Perspectives on the surgical intervention of venous injuries: In-depth analysis

Abstract

Background. The surgical treatment of venous injuries is examined in this work, with particular attention to the brachial vein and its prevalence, methods, and results. Purposes. It assesses surgical techniques, issues that arise after surgery, and the significance of developments in venous repair. In these complicated instances, the research aids in better decision-making and patient care. Methods. A study at the Advanced Vascular Institute and Al-Hashed military hospitals between 2017 and 2018 involved 150 patients with acute venous injuries, predominantly males aged 3-65 years. The study observed a change in the causes of venous injury, with a rise in cases of blunt trauma, particularly in metropolitan areas, but penetrating trauma remains the most common cause. Diagnosis is mainly reached clinically by looking for signs and symptoms, and surgical plans can be made without the Doppler study, which is now available in all casualty wards. Results. To treat hypovolemia and shock, two bilateral wide-bore cannulas with rapid cross-matched blood (rapid method) and ringers or normal saline fluid. The most common injury was to the brachial vein, which was repaired primarily by ligation and, after that, by various techniques, including venography. Follow-ups were difficult for those from other governments, especially our soldier's surgery done at Al-Hashed hospitals, where we advised them to consult vascular surgeons near their residences. Ten individuals had their venous ligation and fasciotomy complications—often accompanied by concomitant artery trauma—required an amputation. Conclusions. The use of fasciotomies varied and did not significantly correlate with the kind of operation. Doppler study checked the patency of the repaired veins, and the follow-up revealed no signs of thrombotic problems. Four patients, all in critical hemodynamic conditions with significant arterial and venous injuries, died during surgery from irreversible shock, accounting for the study's 2.7% fatality rate.