Venous injuries: military versus civilian experience

The acute management of venous injuries remains a controversial topic among practicing surgeons. A literature review encompassing the last half century was performed to clarify the different philosophies proposed in the operative treatment of venous injuries. From a military perspective, the Vietnam Vascular Registry provided the largest single military experience and follow-up of venous injuries to date. The data presented support the concept of the importance of venous repair in attempts at limb salvage when faced with a high-velocity missile wound. The civilian experience (1960-1992) supports the notion that venous ligation in particular circumstances results in little, if any, added morbidity to the patient and may be life-saving in certain instances. The two basic viewpoints are reviewed with regard to pertinent literature and conclusions drawn from these data.