Vascular Trauma- Need to understand to Save Limbs
A trauma care center with a Vascular Surgeon makes a big difference. A Vascular surgeon is trained and qualified to make a quick assessment and intervene in time to salvage a precious limb and life.
Jamshedpur (Jharkhand) [India] August 1 : The Vascular System in the human body is composed of arteries, veins, and capillaries, supplying blood to all parts and organs of the body. There has been a significant increase in cases of Vascular injuries due to trauma sustained in road traffic accidents, falls from heights, high-speed racing sports, assault, war-related, and other penetrating and blunt injuries. It has been found that involvement of the vascular system in blunt trauma is around 1%, going up to 15-17% for penetrating injuries, which may lead to loss of limb and life.
Management of cases of vascular trauma has undergone a sea change over the last few decades. Most of the experience of arterial repair has been obtained during the two World Wars and the Vietnam and Korean wars of the last century.
There should be a high index of suspicion of vascular injuries, especially in cases of Polytrauma resulting in multiple injuries, bony fractures, intra-abdominal and intra-thoracic injuries, and open and closed wounds with or without obvious bleeding. The nature of the injury, external bleeding, expanding hematoma, unexplained shock, pale and calmy peripheries and absence of distal pulses are warning signs. The threshold should be low for referring such patients to a vascular surgical center making a huge difference in the overall outcome.
First aid by the First Responder, usually a nonmedical person at the site of injury could be life-saving. Any exsanguinating injury should be rapidly packed and with a compression dressing should be evacuated to the nearest healthcare facility by the fastest possible means.
At the specialized center, the patient is triaged for the severity of injuries. A thorough clinical and quick evaluation is a must in deciding the plan of care. Life takes precedence over the limb.
A trauma care center with a Vascular Surgeon makes a significant difference. A Vascular surgeon is trained and qualified to make a quick assessment and intervene in time to salvage a precious limb and life. The injured artery is repaired primarily with an interposition graft (vein or prosthetic). Associated injuries are dealt with by a multi-disciplinary team of specialists, as indicated.
The ‘Golden Period’ for repair of the injured vessel and reestablishment of blood supply is within six hours of the injury to prevent irreversible damage to the injured extremity.
The importance of awareness, proper first aid, and timely intervention cannot be over-emphasized, thus saving both limb and life.
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