Vascular trauma

The word "spasm" has been purposefully omitted as it is essentially a nonentity in vascular trauma. The surgeon's ability to repair and salvage extremities has increased greatly in the last 30 years. Problem areas still exist, especially in those patients with carotid trauma and neurologic deficit and patients with massive trauma to the extremities with involvement of bone, arteries, veins, nerves, and soft tissue. There is a place and a time for primary amputation, but its role in trauma surgery has definitely decreased and should continue to do so, as long as in so doing we do not jeopardize the life of the patient.