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Management of military vascular injuries
1Department of Thoracic and Cardiovascular Surgery, Diyarbakir Military Hospital, Diyarbakir, Turkey. kozisik@hotmail.com
Background:
Vascular injuries caused by high-velocity military missiles during war present large and extensive defects of tissues and bones, are often associated with other injuries. In this study we will discuss the surgical strategy and results of military vascular injuries.
Methods:
A retrospective review of records of 63 patients treated between January 1995 and December 1999 was undertaken.
Results:
The mean age of the wounded was 22.3 years (range, 20 to 37 years). The mean time for evacuation from the place of injury to the hospital was 2.3 hours (range, 15 min to 10 hrs). There were 58 (76.3%) arterial and 18 (23.7) venous injuries. Vascular injuries concomitant with 28 (36.9%) bone fractures, six (7.9%) nerve injuries, nine (11.8%) hemopneumothorax and one (1.3%) abdominal injuries. The treatment of the injured arteries were 39 (51.3%) saphenous vein interposition grafting, 13 (17.1%) end to end anastomosis, 12 (15.7%) primary suture, seven (9.2%) synthetic graft replacement. Three patients (3.9%) died because of hypovolemic shock. Five patients underwent amputation (6.6%) and fasciotomy was performed after vascular repair in 11 cases (14.5%).
Conclusions:
At the military vascular injuries, the right timing, and also prompt treatment save the life of the patients and give better qualified living to the patient.