Management of Concomitant Traumatic Abdominal Vascular and Gastrointestinal Injuries: A Descriptive Study

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Surgical Infectious Diseases

Background:

• Intra-abdominal trauma with vascular injury in contaminated fields poses significant surgical challenges.
• Prosthetic grafts are often avoided due to infection concerns, despite limited data.
• Characterizing injury patterns, repair techniques, and outcomes is crucial.

Purpose of the Study:

• To evaluate the outcomes of various reconstructive techniques for traumatic intra-abdominal vascular injuries.
• To compare the safety and efficacy of prosthetic versus biologic grafts in contaminated surgical fields.
• To analyze the impact of gastrointestinal injury type on infectious complications.

Main Methods:

• Retrospective review of adult patients with traumatic intra-abdominal gastrointestinal and major vascular injury.
• Data collected from January 2012 to December 2021.
• Analysis of injury patterns, repair methods (ligation, shunting, stenting, grafts, primary repair), and postoperative outcomes.

Main Results:

• 76 vascular injuries (28 arterial, 48 venous) in 51 patients were analyzed.
• Venous injuries were predominantly ligated; arterial injuries utilized diverse methods.
• No significant difference in intra-abdominal abscesses, bacteremia, or reintervention rates between prosthetic and biologic grafts.
• Colorectal vs. non-colorectal GI injuries showed no difference in infectious complications or reintervention.

Conclusions:

• This series suggests prosthetic grafts are a potentially safe option for traumatic intra-abdominal vascular injuries in contaminated settings.
• Outcomes were comparable between prosthetic and biologic grafts regarding infectious complications.
• Further prospective research is recommended to definitively establish the safety of prosthetic graft use in contaminated fields.