Penetran periferik vasküler yaralanmalar

Yüksel DERELİ, Ramis ÖZDEMİR, Kemalettin HOŞGÖR, Musa AĞRIŞ, Ali Suat ÖZDİŞ, Nihan KAYALAR

Abstract

Objective: We evaluated the surgical treatment of patients with penetrating peripheral vascular injury. Material and Methods: Between January 2005 and January 2011, a total of 231 patients (184 male, 47 female and mean age 29.80 years) who underwent surgical treatment for penetrating peripheral vascular injury were evaluated retrospectively. Results: The causes of injuries were stab wounds in 205 (88.74%) cases and gunshot wounds in 26 (11.26%) cases. Injuries were in the upper extremity in 144 (62.33%) cases and in the lower extremity in 87 (37.67%) cases. The most common anatomical locations of vascular injuries were the radial artery (54 lesions) and superficial femoral artery (37 lesions). As treatment; primary suture in 69 (29.87%) patients, end to end anastomosis in 97 (41.99%) patients, otogenous saphenous vein interposition in 33 (14.28%) patients, synthetic graft interposition in 11 (4.76%) patients and simple ligation in 21 (9.10%) patients were performed. Amputations were performed in 6 (2.59%) patients. Mortality rate was 1.29% with 3 cases. Conclusion: Early diagnosis, urgent surgical intervention, and replacement of fluid and blood play a significant role in decreasing mortality and morbidity. (JAEM 2012; 11: 15-8)

Özet

Amaç: Penetran periferik vasküler yaralanma tanısıyla cerrahi tedavi uygulanan olgular değerlendirildi. Gereç ve Yöntemler: Ocak 2005 ile Ocak 2011 tarihleri arasında, penetran periferik vasküler yaralanma tanısıyla cerrahi tedavi uygulanan 231 hasta (184 erkek, 47 kadın ve ortalama yaş 29.80) retrospektif olarak incelendi. Bulgular: Etiyoloji 205 (%88.74) olguda kesici - delici alet yaralanması ve 26 (%11.26) olguda ateşli silah yaralanması idi. Yaralanma 144 (%62.33) olguda üst ekstremitede ve 87 (%37.67) olguda alt ekstremitede idi. Vasküler yaralanmaların en sık anatomik lokalizasyonu radial arter (54 lezyon) ve yüzeyel femoral arter (37 lezyon) idi. Tedavi olarak; 69 (%29.87) hastada primer tamir, 97 (%41.99) hastada uç-uca anastomoz, 33 (%14.28) hastada otojen safen ven interpozisyonu, 11 (%4.76) hastada sentetik greft interpozisyonu ve 21 (%9.10) hastada ligasyon uygulandı. 6 (%2.59) hastaya amputasyon uygulandı. Mortalite oranı 3 olgu ile %1.29 idi. Sonuç: Periferik vasküler yaralanmalarda morbidite ve mortalitenin düşürülmesinde erken tanı, acil cerrahi müdahale, kan ve sıvı replasmanı önemli rol oynar. (JAEM 2012; 11: 15-8)