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This study reviews 12 years of vascular trauma management during Northern Ireland
Area of Science:
- Vascular surgery
- Trauma management
- Ballistics
Background:
- The Vascular Unit of the Royal Victoria Hospital, Belfast, managed vascular injuries during a 12-year period of civil conflict.
- Injuries resulted from low- and high-velocity missiles and explosions.
- A significant number of injuries involved 'knee-cappings' (punishment shootings), particularly affecting the popliteal vessels.
Purpose of the Study:
- To outline the experience gained in managing vascular injuries.
- To discuss surgical methods developed for vascular trauma.
- To emphasize the surgical approach to injuries in the neck, abdomen, and lower limb.
Main Methods:
- Review of vascular injury cases over a 12-year period.
- Analysis of injury mechanisms (missiles, explosions, 'knee-cappings').
- Description of surgical techniques employed for vascular repair and reconstruction.
Main Results:
- A wide spectrum of vascular injuries was managed.
- Popliteal vessel injuries were frequently associated with punishment shootings.
- Many patients presented with multi-regional trauma in addition to vascular damage.
Conclusions:
- Experience in managing complex vascular trauma was acquired.
- Specific surgical approaches were developed and refined for various anatomical locations.
- The study highlights the challenges and adaptations in vascular surgery during prolonged civil conflict.
Abstract:
Over a 12-year period of civil hostilities in Northern Ireland, the Vascular Unit of the Royal Victoria Hospital, Belfast, has dealt with a wide variety of vascular injuries inflicted by low- and high-velocity missiles and bomb explosions. 'Knee-cappings' or punishment shootings, accounted for a large proportion of popliteal vessel injuries. In addition to specific vascular injuries a majority of patients suffered damage to other regions of the body. Experience gained in the management of vascular injuries is outlined and surgical methods developed here are also discussed. The surgical approach to injuries of vessels in the neck, abdomen and lower limb receive particular emphasis.