Prognostic factors in peripheral vascular injuries
Romanoff, H.; Goldberger, S.
Journal of Cardiovascular Surgery 18(5): 485-491
1977
ISSN/ISBN: 0021-9509 PMID: 591558 Document Number: 110134
A series of 73 patients suffering from peripheral vascular injuries is presented. The injury had been severe in most patients and associated injuries were present in a high percentage of cases. 46% of patients had long bone fractures, 52% had a major peripheral vein injured and 41% had peripheral nerve injuries. End to end anastomosis of the artery had been used in 51% of the cases and vein graft interposition in 46%. 71 patients survived the injury and 56 patients had a viable limb on discharge, or a success rate of 76.7%. Factors which weighed heavily on the prognosis are analyzed. The deleterious effect of the tourniquet is emphasized. Bleeding and shock were more severe in patients with an associated major peripheral vein injury. The latter had a definite influence on limb survival and was responsible for frequent thromboembolic complications. The associated fracture too weighed heavily on the prognosis, as well as infection, and loss of tissue. The associated injuries had a major influence on the final functional result. Function was poor in 10% of patients because of severe neurological deficits or extensive destruction and loss of tissue.