Vascular injuries of the extremities are a major challenge in a third world country

Journal of Trauma Management & Outcomes

Anel R. Bagwani¹  Kamal M. Yousuf³  Fahad H. Khan² 

[1] General Surgery, Liaquat National Hospital, Stadium Road, Karachi 74800, Pakistan;General Surgery, Civil Hospital, Baba-e-Urdu Road, Karachi 75200, Pakistan;Vascular Surgery, Liaquat National Hospital, Stadium Road, Karachi 74800, Pakistan

关键词: Developing countries;    Extremities;    Vascular injuries;    Trauma;   

Others  :  1223383
DOI  :  10.1186/s13032-015-0027-0

 received in 2015-01-02, accepted in 2015-07-21,  发布年份 2015

【 摘 要 】

Background

Traumatic vascular injuries of the extremities are a major challenge especially in the third world countries. These injuries are mostly due to poor traffic laws, street crimes, firearms and blast associated injuries. We therefore would like to share our 10 years of experience in dealing with vascular injuries in Pakistan.

Methods

This was a retrospective observational study conducted in the department of vascular surgery of Liaquat National Hospital, Karachi, Pakistan. Patients’ records were retrieved from the department and were reviewed. Cases with vascular injuries of upper and lower limb that presented with signs of salvageable limb and presented within 12 hours of injury were included in the study. Patients with more than 12 hours of presentation and in whom primary amputation was done, were excluded from the study.

Results

There were 328 patients who presented with vascular injuries of the extremities that fell in the inclusion criteria. Limb salvage rate was 41 %, whereas 30-days perioperative mortality was 5.48 %. The major cause of limb loss was delay in presentation of more than 8 h of injury. Major vessels involved were popliteal artery (41.76 %), followed by femoral artery (27.43 %).

Conclusion

Vascular injuries are becoming a major contributor of limb loss in third world countries due to violence, terrorism and unavailability of vascular facilities. This morbidity can be reduced by improving law and order situation, evolving an effective emergency ambulatory system and with better training and provision of vascular services in remote areas so that the delay factor can be reduced.

【 授权许可】

   
2015 Khan et al.

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