[Surgical repair of major vascular injuries in the extremities complicated by other injuries: retrospective analysis of 67 cases].

OBJECTIVE

To retrospectively analyze the surgical repair of injured major vessels in the extremities complicated by multiple other injuries.

METHODS

According to different time lengths of sustaining ischemia, sites of the major vascular injuries and conditions of other injuries, 91 operations for end-to-end anastomosis, vessel grafting and repair, ligation and shunting respectively were performed on the 67 patients.

RESULTS

Except for 2 fatal cases (one due to preoperative brain hernia and hemorrhagic shock, the other to thyroid crisis during operation), all other cases survived the operations. Vascular crisis occurred in 3 cases (2 arterial spasm and 1 venous crisis) 6, 7 and 12 h respectively after the operations, which were relieved by appropriate treatments and surgical explorations. One patient developed pneumonia and acute renal failure with polyuria at postoperative days 7 and 4 respectively, but full recovery was achieved.

CONCLUSIONS

For patients with major vascular injuries in the extremity complicated by multiple other injuries, timely revascularization of the extremities should be performed during or immediately after emergency operations of the vital organs. Particular attention should be given to the diagnosis and repair of closed major vascular injuries in such patients, who need to be monitored for blood coagulation during operation and should receive due post-operative anti-coagulation treatment.