title: Combat related vascular trauma.
abstract: OBJECTIVE
  To determine the frequency and pattern of different types of vascular injuries, their management and surgical complications.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Combined Military Hospital, Peshawar, from August 2008 to August 2010.
  
  
  METHODS
  All patients of vascular injuries were included. Traumatic amputation, amputation for extensive soft tissue, or nerve injury, death due to reasons other than vascular injuries or Mangled Extremity Severity Score (MESS > 7) were excluded from study. Data included patient profile, time and date of admission, place, site, type and mechanism of injury, associated injuries, vital signs, treatment, type of vascular repair and outcome. Decision to operate was mainly based on clinical diagnosis and hand-held Doppler finding.
  
  
  RESULTS
  There were 170 vascular injuries in 96 patients; 76.4% were arterial and 23.5% were venous. Gunshot wounds was main cause (54%) and extremities were the commonest site (85%). Arteries were repaired in 87% and veins in 40% cases. Venous interposition graft was the preferred method of repair. The overall limb salvage rate was 95%. Thrombosis and infection of the graft and repair were the main causes of secondary amputation. Haemorrhage, reperfusion injury and infection were the main causes of death.
  
  
  CONCLUSIONS
  Every effort should be made to repair an injured artery to preserve a limb and life. Tourniquet, prophylactic fasciotomy and vascular shunts play an important role. Management of life threatening injuries, unstable fracture of long bones and debridement before definitive repair of artery is important.
authors.affiliation: Department of Surgical, Combined Military Hospital, Peshawar. ahmishwani@yahoo.com
authors.forename: Ahmad Hussain
authors.initials: AH
authors.lastname: Mishwani
authors.forename: Abdul
authors.initials: A
authors.lastname: Ghaffar
authors.forename: Sarfaraz
authors.initials: S
authors.lastname: Janjua
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D001158:Arteries / Q000293:injuries* / Q000601:surgery; D005121:Extremities / Q000098:blood supply / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000379:methods*; D014680:Veins / Q000293:injuries* / Q000601:surgery; D014857:Warfare; D014948:Wounds, Gunshot / Q000453:epidemiology / Q000601:surgery*