Overview
Introduction
Trauma, both blunt and penetrating, is extremely common in Africa. As a result, trauma to major vessels, in particular arteries, is a not uncommon clinical occurrence. Some of the pathologic consequences of arterial injury including bleeding and occlusion with tissue ischemia, are acute events demanding immediate intervention to save life and limb and precluding any attempt at transfer or referral. Therefore, the particular specialized surgical skills, techniques and materials for the care of these patients need to be at the disposal of the non-specialist African general surgeon. It is the purpose of this Review to discuss these questions. While it will focus on the treatment of injured arteries, attention will be given to those venous injuries which require surgical repair rather than simple ligation. Finally photographs from the author’s personal experience are presented in “Clinical cases”.
Vascular Trauma
- Vascular trauma can result from either blunt or penetrating injury
- Penetrating injury is more common in the USA than Europe
- Pattern of injury differs according to the mechanism of injury
- Blunt vascular trauma is associated with an increased amputation rate
- Results from blunt injury being associated with significant fractures and tissue loss
- The diagnosis of blunt vascular trauma is often delayed
Types of Vascular Injury
- Contusion
- Puncture
- Laceration
- Transection
Clinical Features
- Depends on site, mechanism and extent of injury
- Signs classically divided into 'hard' and 'soft' sign
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