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[Vascular trauma of the lower limbs]
F Palmieri1, G Pulcini, T Piardi
1Cattedra di Semeiotica Chirurgica Spedali Civili di Brescia, III Divisione di Chirurgia Generale UDA, Università degli Studi, Brescia.
Background:
This study was conducted to evaluate the results of treatment of vascular trauma of the lower extremities and those factors associated with limb loss.
Design:
a retrospective evaluation of a series with lower extremities vascular trauma.
Setting:
University Hospital.
Methods:
Thirty-one patients accounting for 45 vascular lesions of the lower extremities (27 arterial and 18 venous injuries), over a 15 years period ending December 1998. Age, sex, modality of the trauma, site of the lesion and associated skeletal injuries, diagnostic procedures, ischemic time, arterial and venous repair performed were analyzed.
Results:
Perioperative mortality was 7.4%. For arterial injuries, limb salvage was obtained in 22 patients (81.5%). Five amputations (18.5%), 1 primary and 4 secondary have been performed. Amputation rate was 26.7% for popliteal lesions versus 8.3% for other locations, 40% when a skeletal lesion was associated versus 5.9% for those without such injuries, 37.5% for reverse saphenous vein interpositions versus 5.6% for arterial repair without interposition.
Conclusions:
In this study, the factors influencing limb loss in vascular trauma of the lower extremities are popliteal location, the association with skeletal injuries, the need of saphenous vein interposition for arterial repair.