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Traumatic Peripheral Arterial Injury with Open Repair: A 10-Year Single-Institutional Analysis

Cho Ho-Seong, Huh Up, 이충원, 송승환, 김선희, 정성운,
소속 상세정보
 ( Cho Ho-Seong ) - Pusan National University School of Medicine Pusan National University Hospital Department of Thoracic and Cardiovascular Surgery
 ( Huh Up ) - Pusan National University School of Medicine Pusan National University Hospital Department of Thoracic and Cardiovascular Surgery
이충원 ( Lee Chung-Won ) - Pusan National University School of Medicine Pusan National University Hospital Department of Thoracic and Cardiovascular Surgery
송승환 ( Song Seung-Hwan ) - Pusan National University School of Medicine Pusan National University Hospital Department of Thoracic and Cardiovascular Surgery
김선희 ( Kim Seon-Hee ) - Pusan National University School of Medicine Pusan National University Hospital Department of Trauma Surgery
정성운 ( Chung Sung-Woon ) - Pusan National University School of Medicine Pusan National University Hospital Department of Thoracic and Cardiovascular Surgery

Abstract


Background: We report our 10-year experience with traumatic peripheral arterial injury repair at an urban level I trauma center.

Methods: Between January 2007 and December 2016, 28 adult trauma patients presented with traumatic peripheral arterial injuries. Data were retrospectively collected on demographic characteristics, the mechanism of injury, the type of vascular injury, and physiological status on initial assessment. The analysis also included the Mangled Extremity Severity Score (MESS), Injury Severity Score, surgical procedures, and outcome variables including limb salvage, hospital stay, intensive care unit stay, and postoperative vascular complications.

Results: Four (14.3%) patients required amputation due to failed revascularization. MESS significantly differed between patients with blunt and penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005). The amputation rate was not significantly different between patients with blunt and penetrating trauma (20% vs. 0%, respectively; p=0.295). The overall mortality rate was 3.6% (1 patient).

Conclusion: Blunt trauma was associated with higher MESS than penetrating trauma, and amputation was more frequent. In particular, patients with blunt trauma had significantly higher MESS than patients with penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005), and amputation was performed when revascularization failed in cases of blunt trauma of the lower extremity. Therefore, particular care is needed in making treatment decisions for patients with peripheral arterial injuries caused by blunt trauma.

키워드

Blunt trauma; Penetrating trauma; Arteries; Revascularization

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