Effects of the Vascular Injuries on the Prognosis in Traumatic Patients

Jung, Suk In; Cho, Min Young; Son, Gil Soo; Choi, Sang Yong; Whang, Cheung Wung

Abstract

Vascular trauma continues to be a challange for surgeons. A high index of suspicion and a comprehensive, aggressive approach is required to achieve the best possible outcome. Even with much advanced vascular surgical technique and supportive measurement, the mortality and amputation rate of vascular trauma remain high. The peripheral vascular injury associated with the fracture and dislocation was not so common in the civilian practice. But when overlooked, the morbidity was not neglectable. In this study, we retrospectively reviewed 81 cases of vascular trauma which were admitted at Korea University Hospital from Jane, 1990 to June, 1997. Among 81 cases, 56 cases were male and 25 cases were female. The causes of vascular trauma were 40 traffic accidents(49.4%), 23 knife injuries(28.4%), 3 gunshot injuries and 5 cases iatrogenic injuries. The vascular trauma were 67 arterial injuries(82.7%) and 14 venous injury(17.3%). The arterial trauma types were 39 complete transections(58.2%), 20 incomplete transections(29.8%), and venous trauma types with 10 complete transections(71.4%), and 4 incomplete transections. The operation methods in arterial injury were 32 end to end anastomoses(47.8%), 21 patch grafts(31.3%) and 6 ligations(9%). Amputation rates in lower extremity injuries were significantly higher in the early operation cases than the late operation cases and combined with fractures than those without fractures. Mortality was higher in the aortic and IVC injuries than the extremity injuries. In conclusion, this study shows that the prognosis of vascular injuries can be improved by rapid transport, early fixation of fracture, and involement of qulified traumatic surgeon.