Challenges in the management of extremity vascular injuries: A wartime experience from a tertiary centre in Sri Lanka
| Autor: | Wdd de Silva, Charitha Weerasinghe, S.M. Wijeyaratne, Ranjuka Arushana Ubayasiri |
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| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
education.field_of_study business.industry Tertiary referral centre Limb salvage Population lcsh:Surgery lcsh:Medical emergencies. Critical care. Intensive care. First aid Alternative medicine Developing country lcsh:RD1-811 lcsh:RC86-88.9 medicine.disease Intervention (counseling) Emergency medicine medicine Emergency Medicine Surgery Medical emergency Sri lanka education business Limited resources Research Article |
| Zdroj: | World Journal of Emergency Surgery : WJES World Journal of Emergency Surgery, Vol 6, Iss 1, p 24 (2011) |
| ISSN: | 1749-7922 |
| Popis: | Background Management of peripheral vascular injuries often present critical challenges in resource limited settings of developing countries. The additional burden from a military conflict poses further challenges. Delays in presentation often result in the loss of limb and even life, in what is usually a young active population. The objective of this report is to analyse the early outcome of vascular intervention at a tertiary referral centre in Sri Lanka. Methods A retrospective descriptive review of eighty one consecutive extremity vascular injuries in seventy patients during a seven month period was performed with regards to the cause of injury, types of presentations, ischaemia time, interventional procedures, complications and early outcome. Results Mean age was 31.2 years (9-72 years) and 96% were males. Injuries were caused by blasts in 41%, cuts in 26%, gunshots in 17% and road traffic injuries in 9%. Indications for revascularization were acute ischaemia in 44%, active bleeding in 43% and pseudo-aneurysms in 13%. Six patients underwent primary amputations due to non-viable limbs. 64 patients underwent vascular intervention. Fifty one percent needed vein grafts while 46% had direct repairs. Bleeding was often (73%) from upper extremity injuries. Median time to revascularization was 5.5 (2-16) hours with all limbs salvaged. Acute ischaemia (40%) was often from popliteal injuries. Median time to revascularization was 10 (5-18) hours and viability was prejudged at fasciotomy. 92% of revascularized limbs were salvaged. There was no perioperative mortality. Conclusions Results from vascular repairs are encouraging despite significant delays. |
| Databáze: | OpenAIRE |
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