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末梢動脈 損傷 21例

Peripheral Arterial Injuries with Particular Reference to Value of Perfusion of Distal Artery

대한외과학회지 1966년 8권 11호 p.625 ~ 629
김은섭,
소속 상세정보
김은섭 (  ) - 수도육군병원 외과

Abstract


1. 21 cases of acute arterial injuries are reported. Of 21 cases arterial repair was carried out on 18 cases, end to end anastosis on 14 cases, autogenous vein graft on 3 cases and lateral suture on 1 case. Ligation was carried out on 3 cases of minor arterial injuries without development of gangene.
2. Of 21 procedures, 14 procedures were succesful with salvage of affected limbs. 7 cases subsequently required amputation of the affected limbs-causes being 1 throumbosis, 3 irreversible muscle damage, 2 massive soft tissue injuries and 1 phlegmasia cerulea dolens.
3. On 9 cases the distal arterial segment was perfused with perfusate consisting of 1,000 cc of Dextran, 1.0 cc of 1% Procain Hcl and 20,000 u of Heparin Scd. Indication for perfusion was 1. Poor or absent back-bleeding at the time of surgery, 2. Long duration from injury to surgery, 3. Change in skin color. Perfusion definitley improved back-beelding and run-off following the anastomosis. Perfusion was carried out throuth a 12-14 F. polyethylene tube placed in the distal artery by gravitation until back-bleeding improved. The amount of perfusate in most cases did not exceed 500 cc.
4. Appropriate surgical procedures were carried out for concommitent injuries. Nerves if injured were repaired primarily if feasible, as were veins.
5. One case with diffuse injuries of veins on whom deep venous repair could not be performed developed classical type of phlegmasia cerulea dolens, and expired of septic pulmonary emboli. This suggests hat acute deep venous insufficiency should be corrected.

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