Gunshot injuries of the popliteal artery

Citation
R. Nair et al., Gunshot injuries of the popliteal artery, BR J SURG, 87(5), 2000, pp. 602-607
Citations number
27
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
BRITISH JOURNAL OF SURGERY
ISSN journal
0007-1323 → ACNP
Volume
87
Issue
5
Year of publication
2000
Pages
602 - 607
Database
ISI
SICI code
0007-1323(200005)87:5<602:GIOTPA>2.0.ZU;2-S
Abstract
Background: Guidelines for the management of popliteal artery trauma emanat e mainly from military experience. This study was undertaken to describe th e management of popliteal injuries in a civilian vascular surgical unit wit h a large trauma workload. Methods: A retrospective review of records of patients treated between 1983 and 1997 was undertaken. Results: Some 117 popliteal artery gunshot injuries were treated (83 low ve locity, 16 high velocity, 18 shotgun), Associated fractures occurred in 44 patients and 40 had popliteal vein injuries. Treatment of the arterial inju ry included vein graft interposition in 71, primary reanastomosis in 19, pr osthetic graft interposition in four, lateral suture in one, vein patch in one and ligation in one patient; 84 fasciotomies were performed. No periope rative deaths occurred, There were 20 primary and 14 secondary amputations. Factors associated with amputation were high-velocity injuries, delay in r evascularization in excess of 7h, arterial transection, associated fracture , and compartment syndrome or muscle infarction. Conclusion: Civilian popliteal gunshot injuries are attended by a high ampu tation rate, Prompt resuscitation and revascularization appear to be the on ly correctable factors that may improve limb salvage rates.