[Surgical management of vascular injury of extremities].
OBJECTIVE
To summarize the importance of surgical management to repair vascular injury in limbs salvage, and to analyze the influence factors in the management.


METHODS
From 1993 to 2000, 42 cases of 58 vascular injuries were reviewed; there were 37 males and 5 females, aging from 12 to 70 years old. Emergency operations were performed in 38 cases and selective operations in 4 cases from 1 hour to 45 days after injury. There were 22 cases of complete rupture in 32 blood vessels, 5 cases of partial rupture in 6 blood vessels, and 15 cases of vascular defect in 20 blood vessels, with 5 cm to 10 cm defect. The operation management included end-to-end anastomosis in 22 cases, side-to-end anastomosis in 1 case, vascular repair in 5 cases and vascular grafting in 14 cases. All of the cases were followed up for 6 months to 7 years.


RESULTS
In those received emergency operations, it was successful in 35 cases, with amputation in the other 3 cases; after operation, there were 5 cases of post-operative angio-crisis, 1 case of hematoma and 1 case of pseudoaneurysm. In those received selective operation, all succeeded but 1 case of post-operative angio-crisis. After the follow-up, except for 3 cases of amputation, the other limbs survived; and function of the survived limbs recovered satisfactorily after operation except poor recovery in 7 cases of replantation of the limbs.


CONCLUSIONS
To repair vascular injury immediately, to manage angio-crisis and to remove influence factors is the key to save the injured limbs and to maintain the function of them.
Wei
Zheng-chao
ZC
Department of Orthopedic Surgery, 3rd Affiliated Hospital of Sun Yat-sen Medical University, Guangzhou Guangdong, P. R. China 510630.
Jing
Wen-tao
WT
Zhang
Jun-feng
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D001808:Blood Vessels / Q000293:injuries*; D002648:Child; D005121:Extremities / Q000098:blood supply / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012501:Saphenous Vein / Q000637:transplantation; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000379:methods*