War injuries of the blood vessels of the extremities

• Main Authors: Radulović Svetozar, Despot Branko, Papić Vladimir, Pušac Branislava, Trkulja Nebojša
• Format: Article
• Language: English
• Published: Military Health Department, Ministry of Defance, Serbia 2002-01-01
• Series: Vojnosanitetski Pregled
• Subjects: arteries; veins; wounds, penetrating; vascular surgical procedures; amputation; military medicine; war
• Online Access: http://www.doiserbia.nb.rs/img/doi/0042-8450/2002/0042-84500202153R.pdf

Treatment results of 200 injured with the lesions of 282 magisterial blood vessels were analyzed. All were combat injuries, and the majority was caused by the fragments of explosive device. The mechanism of such the injuries produced large defects of soft tissues as well as the high level of the wound contamination, which aggravated reconstructive procedures and increased the risk of infection. In the majority of cases anatomic reconstruction of the artery was performed, and the ligature was used only in the case of graft infection and in the injuries of one artery of the lower leg or the forearm. The majority of injuries was solved by lateral suture or patch plastic, since postoperative constriction caused by those methods did not cause greater hemodynamic disorders due to the size of venous lumen. The duration of ischemic interval was of the utmost importance for the favorable final result of the treatment, as well as the adequate debridement of the wound, good soft-tissue cover of the reconstructed blood vessel and precise a traumatic technique. Total percentage of amputations was 14.5%, and all were involving the lower extremities, and were mostly caused by popliteal artery lesion.