title: Assessment of Vascular Injuries and Reconstruction.
abstract: BACKGROUND
  Trauma is the third leading cause of death. In this regard, vascular injury plays a leading role in of morbidity and mortality rates.
  
  
  OBJECTIVE
  The present study aimed to assess the prevalence of vascular injuries and results of vascular reconstruction at a referral hospital in northern Iran.
  
  
  METHODS
  A retrospective observational study assessed 88 consecutive patients with vascular injury admitted to Poursina Hospital, Rasht in northern Iran, from October 2007 to October 2009. All study information was collected retrospectively from hospital charts.
  
  
  RESULTS
  Most of the affected patients (87/88) were male with a mean age of 29.12 ± 11.20 years. The mechanism of injury in 39.8% was blunt trauma and penetrating trauma in the rest. Of the 53 injured by penetrating trauma (60.2%), the most common cause was stabbing (94.3%). The most common cause of blunt trauma was road traffic accidents (93.1%). The most common mechanism for vascular injuries in upper extremities was penetrating trauma (86.0%) and in lower extremities was blunt trauma (60.0%). Fasciotomy was performed in 16 patients (18.2%) mostly in the lower extremities. Major amputation was required in 10% of the patients. In upper extremities, the most common type of revascularization was end to end anastomosis, followed by inter-position graft. The most common type of reconstruction in the lower extremity was bypass graft. All patients who underwent major amputation were admitted to the center with a delay of more than 6 hours after injury.
  
  
  CONCLUSIONS
  Major vascular injuries in our center occurred in young men, frequently because of stab wounds. Popliteal injuries mostly caused by motor vehicle accidents was the second most common arterial injury, followed by combined ulnar and radial injuries. Vascular reconstruction in the first hours after trauma may prevent many unnecessary and preventable amputation procedures.
authors.affiliation: Guilan Road Trauma Research Center, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran; Department of General Surgery, Faculty of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran.
authors.forename: Iraj
authors.initials: I
authors.lastname: Baghi
authors.affiliation: Department of General Surgery, Faculty of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran.
authors.forename: Mohammad Rasool
authors.initials: MR
authors.lastname: Herfatkar
authors.affiliation: Department of General Surgery, Faculty of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Shokrgozar
authors.affiliation: Department of General Surgery, Faculty of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Poor-Rasuli
authors.affiliation: General Physician, Guilan Road Trauma Research Center, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Aghajani
keywords: Amputation; Fasciotomy; Popliteal Injuries; Trauma; Vascular Injuries
references.citation: Ann Vasc Surg. 2009 Jan-Feb;23(1):8-16
references.pmid: 18640813
references.citation: J Ayub Med Coll Abbottabad. 2005 Apr-Jun;17(2):40-3
references.pmid: 16092649
references.citation: N Z Med J. 2004 Sep 10;117(1201):U1048
references.pmid: 15476008
references.citation: Unfallchirurg. 2014 May;117(5):445-59; quiz 460
references.pmid: 24831872
references.citation: Zentralbl Chir. 2002 Aug;127(8):689-93
references.pmid: 12200731
references.citation: Ann R Coll Surg Engl. 2001 Nov;83(6):388-91
references.pmid: 11777132
references.citation: Vascular. 2005 May-Jun;13(3):141-7
references.pmid: 15996371
references.citation: J Trauma. 2011 Jun;70(6):1551-6
references.pmid: 21817992
references.citation: J Trauma Acute Care Surg. 2012 Nov;73(5 Suppl 4):S315-20
references.pmid: 23114487
references.citation: Saudi Med J. 2004 Apr;25(4):498-501
references.pmid: 15083224
references.citation: Ann Thorac Cardiovasc Surg. 2004 Dec;10(6):373-8
references.pmid: 15658911
references.citation: World J Emerg Surg. 2012 Jul 20;7(1):24
references.pmid: 22817978
references.citation: Injury. 2005 Mar;36(3):400-6
references.pmid: 15710157
references.citation: Surg Clin North Am. 2002 Feb;82(1):175-88
references.pmid: 11905944
references.citation: Angiol Sosud Khir. 2004;10(3):104-13
references.pmid: 15622401