Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops
Purpose Penetrating vascular trauma though less common poses a challenge to all Surgeons. This study was designed to analyse the profile, management modalities of vascular trauma and the outcomes thereof at a Trauma Care Centre in a Tertiary care setting in hostile environment in India. Methods A pr...
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| Language: | English |
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Korean Society of Traumatology
2019-06-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://www.jtraumainj.org/upload/pdf/jti-32-093.pdf |
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| author | Rishi Dhillan Alok Bhalla Sushil Kumar Jha Hakam Singh Aman Arora |
| author_facet | Rishi Dhillan Alok Bhalla Sushil Kumar Jha Hakam Singh Aman Arora |
| author_sort | Rishi Dhillan |
| collection | DOAJ |
| description | Purpose Penetrating vascular trauma though less common poses a challenge to all Surgeons. This study was designed to analyse the profile, management modalities of vascular trauma and the outcomes thereof at a Trauma Care Centre in a Tertiary care setting in hostile environment in India. Methods A prospective review of all patients with arterial and venous injuries being transferred to the Trauma Center at out Tertiary Care Center between June 2015 and May 2018 was done. Demographics, admission data, treatment, and complications were reviewed. Results There were a total of 46 patients with 65 vascular injuries, 39 arterial injuries and 26 venous injuries. The age range was 21 to 47 years. Nineteen patients had both arterial and venous injuries. A total of 42 cases presented within 12 hours of injury and complete arterial transections were found in 33 cases (80.49%). There were three mortalities (6.52%) and three amputations (8.33%). The overall limb salvage rate was 91.67% with popliteal artery being the commonest injured artery. Poor prognosticators for limb salvage were increasing time to present to the trauma centre, hypovolemic shock, multi-organ trauma and associated venous injuries. Conclusions Penetrating missile trauma leading to vascular injuries has not been widely reported. Attempting limb salvage even in cases with delayed presentation should be weighed with the threat to life before revascularisation and should preferably be done at a centre with vascular expertise. A team approach with vascular, orthopaedic, general surgeons, and critical care anaesthesiologists all aboard improve the outcomes manifold. Use of tourniquets and early fasciotomies have been emphasized as is the use of native veins as the bypass conduit. This is probably the largest study on penetrating Vascular trauma in anti-terrorism ops from the Indian subcontinent. It highlights the significance of prompt recognition and availability of vascular expertise in optimally managing cases of vascular trauma. |
| format | Article |
| id | doaj-art-6ddfbfde4d0944998a658bc193b28391 |
| institution | Kabale University |
| issn | 1738-8767 2287-1683 |
| language | English |
| publishDate | 2019-06-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-6ddfbfde4d0944998a658bc193b283912025-01-06T01:15:48ZengKorean Society of TraumatologyJournal of Trauma and Injury1738-87672287-16832019-06-013229310010.20408/jti.2018.032985Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism OpsRishi Dhillan0Alok Bhalla1Sushil Kumar Jha2Hakam Singh3Aman Arora4Department of Surgery, Base Hospital, Srinagar, IndiaDepartment of Surgery, Base Hospital, Srinagar, IndiaDepartment of Surgery, Base Hospital, Srinagar, IndiaDepartment of Surgery, Base Hospital, Srinagar, IndiaDepartment of Surgery, Base Hospital, Srinagar, IndiaPurpose Penetrating vascular trauma though less common poses a challenge to all Surgeons. This study was designed to analyse the profile, management modalities of vascular trauma and the outcomes thereof at a Trauma Care Centre in a Tertiary care setting in hostile environment in India. Methods A prospective review of all patients with arterial and venous injuries being transferred to the Trauma Center at out Tertiary Care Center between June 2015 and May 2018 was done. Demographics, admission data, treatment, and complications were reviewed. Results There were a total of 46 patients with 65 vascular injuries, 39 arterial injuries and 26 venous injuries. The age range was 21 to 47 years. Nineteen patients had both arterial and venous injuries. A total of 42 cases presented within 12 hours of injury and complete arterial transections were found in 33 cases (80.49%). There were three mortalities (6.52%) and three amputations (8.33%). The overall limb salvage rate was 91.67% with popliteal artery being the commonest injured artery. Poor prognosticators for limb salvage were increasing time to present to the trauma centre, hypovolemic shock, multi-organ trauma and associated venous injuries. Conclusions Penetrating missile trauma leading to vascular injuries has not been widely reported. Attempting limb salvage even in cases with delayed presentation should be weighed with the threat to life before revascularisation and should preferably be done at a centre with vascular expertise. A team approach with vascular, orthopaedic, general surgeons, and critical care anaesthesiologists all aboard improve the outcomes manifold. Use of tourniquets and early fasciotomies have been emphasized as is the use of native veins as the bypass conduit. This is probably the largest study on penetrating Vascular trauma in anti-terrorism ops from the Indian subcontinent. It highlights the significance of prompt recognition and availability of vascular expertise in optimally managing cases of vascular trauma.http://www.jtraumainj.org/upload/pdf/jti-32-093.pdfpenetrating vascular traumablast injuriestrauma centerfasciotomyvascular trauma terrorism |
| spellingShingle | Rishi Dhillan Alok Bhalla Sushil Kumar Jha Hakam Singh Aman Arora Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops Journal of Trauma and Injury penetrating vascular trauma blast injuries trauma center fasciotomy vascular trauma terrorism |
| title | Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops |
| title_full | Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops |
| title_fullStr | Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops |
| title_full_unstemmed | Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops |
| title_short | Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops |
| title_sort | vascular injuries due to penetrating missile trauma in anti terrorism ops |
| topic | penetrating vascular trauma blast injuries trauma center fasciotomy vascular trauma terrorism |
| url | http://www.jtraumainj.org/upload/pdf/jti-32-093.pdf |
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