CORRELATION BETWEEN KIDNEY AND LIVER IMPAIRMENT WITH OUTCOME IN LIMB VASCULAR TRAUMA

Authors

  • Cristina STROBESCU-CIOBANU “Sf. Spiridon” County Clinical Emergency Hospital Iasi
  • Livia Genoveva BAROI “Sf. Spiridon” County Clinical Emergency Hospital Iasi
  • Ana-Maria VRÂNCIANU “Sf. Spiridon” County Clinical Emergency Hospital Iasi
  • C. VELICESCU “Sf. Spiridon” County Clinical Emergency Hospital Iasi
  • Mădălina Gabriela URMĂ “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • R.F. POPA “Sf. Spiridon” County Clinical Emergency Hospital Iasi

Keywords:

VASCULAR TRAUMA, ACUTE ISCHEMIA

Abstract

Vascular trauma represents one of the most challenging surgical emergencies. The management starts in the prehospital phase and is completed by the intervention of the vascular surgeon. Vascular trauma has a high mortality and morbidity rate, depending on the type of mechanism, localization and associated lesions and it is frequently associated with long term complications. Material and methods: This paper includes 146 consecutive patients with limb trauma admitted to the Department of Vascular Surgery of the “Sf. Spiridon” County Clinical Emergency Hospital, between 2011 and 2022. From the total number, 79.59% were male patients, 73.28% from rural area, mean age 45 years old. Results: The most frequent trauma involved the upper limb with 93 cases (brachial artery - 51 cases, axillary artery - 23 cases), followed by lower limb with 54 cases. Thirty-four cases had vascular lesions involving the nerves and 47 cases were associated with venous lesions. The most frequent mechanism was penetrating lesions via stabbing or cutting (59.59%). Intra operatively, the following procedures were performed: simple exploration and hemostasis, end-to-end anastomosis, interpositions, and bypass. Seventeen patients required amputation, and 10 had decompression fasciotomies. Conclusions: The prolonged time of ischemia (> 6 hours), hemorrhagic shock, reperfusion syndrome with renal or hepatic impairment are highly correlated with an increased risk of amputation and mortality.

Author Biographies

  • Cristina STROBESCU-CIOBANU, “Sf. Spiridon” County Clinical Emergency Hospital Iasi

    Department of Vascular Surgery
    “Grigore T. Popa” University of Medicine and Pharmacy Iasi
    Faculty of Medicine

  • Livia Genoveva BAROI, “Sf. Spiridon” County Clinical Emergency Hospital Iasi

    Department of Vascular Surgery
    “Grigore T. Popa” University of Medicine and Pharmacy Iasi
    Faculty of Medicine

  • Ana-Maria VRÂNCIANU, “Sf. Spiridon” County Clinical Emergency Hospital Iasi

    Department of Vascular Surgery

  • C. VELICESCU, “Sf. Spiridon” County Clinical Emergency Hospital Iasi

    Department of Surgery (I)

  • Mădălina Gabriela URMĂ, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine

  • R.F. POPA, “Sf. Spiridon” County Clinical Emergency Hospital Iasi

    Department of Vascular Surgery
    “Grigore T. Popa” University of Medicine and Pharmacy Iasi
    Faculty of Medicine

References

1. Berlatzky Y, Wolf Y, Anner H. Management of Complex Vascular Trauma Eur J Vasc Endovasc Surg 1998; 16(3): 181-184.
2. Sobrino J, Shafi S. Timing and causes of death after injuries. Proceedings 2013; 26(2): 120-123.
3. Tobin SA, Gurry JF, Doyle JC, Connell JL, Vidovich JD. Vascular trauma at a university teaching hospital. Aust N Z J Surg 1988; 58 (11): 873-877.
4. Razmadze A. Vascular injuries of the limbs: a fifteen-year Georgian experience. Eur J Vasc Endovasc Surg 1999; 18 (3): 235-239.
5. Kjellström T, Risberg B. Vascular trauma. Review of 10 years’ experience. Acta Chir Scand 1980; 146 (4): 261-265.
6. Magee TR, Collin J, Hands LJ, Gray DW, Roake J. A ten-year audit of surgery for vascular trauma in a British teaching hospital. Eur J Vasc Endovasc Surg 1996; 12 (4): 424-427.
7. Sandeep M, et al. Factors Affecting Management and Limb Salvage in Upper Limb Vascular Trauma A Prospective Study of 52 Cases in a Tertiary Care Centre. 2019; 58 (6): E 633 / doi:10.1016/j. ejvs.2019.09.124.

Additional Files

Published

2023-06-30