[Vascular care in devastating injuries of the extremities]

The authors present an account on the treatment of blood vessels in 15 patients with serious devastating injuries of the extremities in 1982-1989. In 10 patients the injury was on the upper and in 5 on the lower extremity. In the majority of patients for reconstruction of arteries and veins venous grafts were used. In 8 patients, i.e. in 53.3%, the result was good, in 2, i.e. 13.3%, it was satisfactory and in 5, i.e. 33.3% patients, a secondary amputation had to be performed. The authors describe the surgical procedure and emphasize the necessity of team work of the vascular surgeon, traumatic surgeon and possibly plastic surgeon in the treatment of devastating injuries of the extremities. The authors draw attention to the importance of compartment and reperfusion syndrome which may complicate these injuries, as well as to the role of free oxygen radicals and the necessity to influence their noxious effect during treatment of these injuries during the per- and postoperative period.