title: Management of vascular injuries in the lower extremities.
abstract: From 1981 through 1985, 220 consecutive patients with presumed vascular injuries in the lower extremities underwent operation at the Ben Taub General Hospital. More than 81% of injuries were due to penetrating wounds, and blunt and iatrogenic injuries accounted for the remainder. A preoperative emergency center arteriogram was performed in 63.2% of patients, and physical examination alone prompted operation in 36.8%. Eight patients underwent immediate amputation; the remaining 212 patients were found to have 225 arterial (63.9%) and 127 venous (36.1%) injuries. More than 50% of patients were noted to have both arterial and venous injuries. Arterial repair was most commonly accomplished by segmental resection with an end-to-end anastomosis (28.4%) or insertion of a graft (38.8%). Venous repair was most commonly accomplished by lateral venorrhaphy (48.8%), ligation (19.7%), or insertion of a conduit (18.1%). Postoperative infection in closed wounds, in wounds left open because of the magnitude of injury, and in adjacent fractured bone occurred in 13% of patients. Late amputations were necessary in only four patients, three of whom had infection as the cause.
authors.affiliation: Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, TX 77030.
authors.forename: D V
authors.initials: DV
authors.lastname: Feliciano
authors.forename: K
authors.initials: K
authors.lastname: Herskowitz
authors.forename: R B
authors.initials: RB
authors.lastname: O'Gorman
authors.forename: P A
authors.initials: PA
authors.lastname: Cruse
authors.forename: M L
authors.initials: ML
authors.lastname: Brandt
authors.forename: J M
authors.initials: JM
authors.lastname: Burch
authors.forename: K L
authors.initials: KL
authors.lastname: Mattox
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D000783:Aneurysm / Q000209:etiology / Q000601:surgery; D000792:Angiography; D001807:Blood Vessel Prosthesis; D001808:Blood Vessels / Q000293:injuries*; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012501:Saphenous Vein / Q000637:transplantation; D014182:Transplantation, Autologous; D014656:Vascular Surgical Procedures / Q000379:methods*; D014946:Wound Infection / Q000453:epidemiology; D014950:Wounds, Penetrating / Q000601:surgery*