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IJHSR. 2013; 3(6): 12-16


Management of Vascular Injury in Rural Setup.

Ashok Y Kshirsagar, Rahul K Patil, Nitin R Nangare, Pandurang Barve.

Abstract
Background: Trauma to the extremities results in combination of injuries ranging from injury to the soft tissue, vasculature, muscle, tendon, neurovascular bundle. Due to the proximity for access to the national highway, high-velocity trauma is very common in our area. Also the population density in our zone leads to more number of paediatric patients with upper limb trauma on the play grounds and household trauma.
Settings: This is retrospective, descriptive and observational study conducted at Krishna institute of medical sciences Karad. Total 46 patients of vascular injury were treated from January 2006 to December 2010.
Material & methods: The vascularity of all patients admitted with vascular injury in the extremity was assessed with pulse-ox meter and Colour Doppler study. The management involved fluid resuscitation, correction of hypotension and immediate operative intervention. Oxygen saturation and pulse volume of both traumatized and healthy upper extremities were studied with pulse-ox meter.
Results: Out of total 46 patients of vascular injury 24 were in the upper extremity, 21 in the lower extremity and one involving the inferior vena cava. 20 patients had transection of vessel, 5 had contusion, 21 contusions with partial tear of the vessel. Great saphenous vein graft was used in two upper & two lower limbs each and the remaining 42 were sutured end to end. Primary skeletal stabilization was done in those with bone involvement.
Conclusions: To conclude, careful evaluation of the neurovascular bundle in the injured extremity and subsequently early exploration and repair of arterial injury can help in saving the limb with restoration of function with less morbidity.

Key words: Key Words: vascular injury; pulse ox- meter; inferior vena cava



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