[Long-term results of peripheral vascular injuries in patients' limbs following reconstructive surgical procedures and influence on the quality of life].
Major vascular injuries in extremities are rare and constitute problems for surgeons and their sequelae strongly influence remote future of the patients. The aim of study is to evaluate surgical treatment of vascular injuries in extremities and some aspects of quality of life. Since 1983 until 2002 sixty four patients with vascular limbs injuries were treated in the department. Remote evaluation has been performed in 33 persons. Severity of limb injuries was measured by Mangled Extremity Severity Score (MESS). In 20 patients (60.6%) very good and good recent results were obtained, satisfactory in 24.2% and bad results in 15.2% persons. Evaluation of functional status has been made by means of locomotion test and Jebsen-Taylor's test, social approval questionnaire, depression Beck's scale, the scale of hypochondria and by an original questionnaire to evaluate the quality of life. As considerable interdependence has been found between the functional status and the following factors: injury severity expressed in MESS (p < 0.01), clinic reception procedure (p < 0.001), ischemia time (p < 0.01), coincidence of other injuries (fractures and dislocations, muscle, tendon and nerve lesions) (p < 0.01), limb amputation (p < 0.01). Hand function significantly influences the quality of life. Patients who were in shock after trauma in the remote assessment showed susceptibility to the lowered mood and depression (p < 0.05). Quality of life is strongly connected with the features of personality, correlating mainly with the mood and tendencies of concentration upon somatic symptoms. Function of the hand influences strongly the quality of life. Amputated patients may in spite of their crippling limitations are able to adapt to everyday life.
Deja
Włodzimierz
W
Z Katedry i Kliniki Chirurgii Urazowej, Akademii Medycznej, Gdańsku.
Wieczorek
Dariusz
D
Deja
Agata
A
Lasek
Jerzy
J
Kawecka
Aleksandra
A
Marks
Wojciech
W
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000523:psychology / Q000706:statistics & numerical data; D001132:Arm / Q000098:blood supply*; D001134:Arm Injuries / Q000145:classification / Q000523:psychology / Q000601:surgery*; D001808:Blood Vessels / Q000293:injuries*; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D007869:Leg Injuries / Q000145:classification / Q000523:psychology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000523:psychology / Q000601:surgery; D011446:Prospective Studies; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000523:psychology* / Q000706:statistics & numerical data