Outcome of arterial repairs in 23 consecutive patients at the ICRC-Peshawar hospital for war wounded.
Arterial injuries represent a formidable challenge to surgeons working in war zone conditions. A series of 23 consecutive patients with combat wounds from the Afghan conflict with acute arterial injury were treated at the ICRC hospital in Peshawar. The mean injury-treatment delay (lag time) was 34 hours, with 14 of the 23 patients (60%) treated more than 12 hours after injury. The overall amputation rate was 65%, but only 22% for patients revascularized within 12 hours of injury and 93% for those undergoing surgery after 12 hours. This was a highly significant statistical difference (Chi-square > 13.0, p < 0.005). We recommend attempting revascularization procedures only in patients seen within 12 hours of sustaining a military-type injury to an artery in an extremity.
Gosselin
R A
RA
Space Coast Orthopedic Center, Merritt Island, FL 32953.
Siegberg
C J
CJ
Coupland
R
R
Agerskov
K
K
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000346:Afghanistan; D000368:Aged; D000671:Amputation, Surgical; D001158:Arteries / Q000293:injuries* / Q000601:surgery; D001753:Blast Injuries / Q000150:complications* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D012011:Red Cross; D013997:Time Factors; D016896:Treatment Outcome; D014857:Warfare; D014948:Wounds, Gunshot / Q000150:complications* / Q000601:surgery