Experience with 115 civilian venous injuries
| Autor: | Benedict M. Reynolds, Pravin M. Shah, William M. Stahl, Roy H. Clauss, Nanakram Agarwal |
|---|---|
| Rok vydání: | 1982 |
| Předmět: |
Adult
Male medicine.medical_specialty Foot drop Adolescent medicine.medical_treatment Venography Critical Care and Intensive Care Medicine Compartment Syndromes Fasciotomy Veins Postoperative Complications Edema medicine Humans Child Ligation Retrospective Studies medicine.diagnostic_test business.industry Incidence (epidemiology) Retrospective cohort study Middle Aged Surgery Total mortality Child Preschool Emergency medicine Female medicine.symptom business |
| Zdroj: | The Journal of trauma. 22(10) |
| ISSN: | 0022-5282 |
| Popis: | Retrospective analysis of 115 patients with venous injuries managed at Lincoln Hospital in a 7-year period disclosed a total mortality of 15%. Retrohepatic caval injury was uniformly fatal; infrarenal caval injury was not. Fifty-six per cent of victims of truncal venoarterial injuries died. Isolated venous injury of the extremity was never lethal. Ligation of injured veins of the neck and upper extremities was well tolerated. Ligation of external iliac, or common femoral, or superficial femoral veins resulted in edema in 50% of the patients compared to 7% after repair (p less than 0.05). Venoarterial injuries of iliac or femoral-level veins resulted in 37% incidence of compartment syndrome against 5% in isolated arterial injuries (p less than 0.01). Therapeutic fasciotomy after the onset of clinically evident compartment syndrome did not prevent foot drop in any patient. We advocate that all major veins of the lower extremities be repaired with the same care as arterial injuries. Prophylactic fasciotomy for all patients with iliac or femoral venoarterial injuries should be considered as strongly as with popliteal venoarterial injuries. The caliber and patency of repaired veins must be assessed by venography at operation, and again before discharge from the hospital. |
| Databáze: | OpenAIRE |
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