[Vascular injuries in war]

Area of Science:

• Vascular surgery
• Trauma surgery
• Military medicine

Context:

• War-related injuries present unique challenges for vascular surgeons, differing significantly from civilian cases.
• This review focuses on surgical procedures for arterial and venous injuries, including soft tissue and bone damage, and their management.
• The study addresses the complexities of treating vascular trauma in a conflict zone.

Purpose:

• To review military vascular injuries sustained in Southern Croatia between June 1991 and December 1993.
• To analyze surgical techniques, outcomes, and adjunctive therapies for vascular trauma.
• To highlight the importance of limb salvage strategies and hyperbaric oxygenation in war casualties.

Summary:

• A retrospective review of 189 patients with vascular injuries, predominantly caused by explosive weapons.
• Surgical techniques included debridement, fasciotomy, microsurgery, and autogenous grafts, with hyperbaric oxygenation used for prolonged ischemia.
• Outcomes included a 3.2% mortality rate and 15.1% amputation rate, underscoring the severity of these injuries.

Impact:

• The findings support the reconstruction of major vessel damage to achieve limb salvage.
• Regular follow-up by multidisciplinary teams is essential for optimizing patient outcomes.
• The study advocates for the increased use of hyperbaric oxygenation in managing war-related vascular injuries.