Ganie Farooq Ahmad, Lone Hafeezulla, Wani Mohd Lateef, Ahmad Dar Farooq, Wani Nasir-U-Din, Wani Shadab Nabi
Department of Resident Cardiovascular and thoracic surgery, SKIMS Soura, Srinagar, India.
Trauma Mon. 2012 Summer;17(2):287-90. doi: 10.5812/traumamon.5368. Epub 2012 Jul 31.
Vascular injury represents less than 1% of all injuries, but deserves special attention because of its severe complications. Amputation or retention of a painful functionless limb is the most untoward result of severe vascular injury or inadequate treatmet. Thus, vascular injury needs a judicious and multidimensional approach.
This retrospective study was done to asess the outcome of minor modifications of the methodology of extremity fasciotomy by making it liberal with respect to incision and definition.
Out of 55 patients in 2008, 45 patients (Group A) had either no fasciotomy or limited primary fasciotomy, 10 patients (Group B) had primary liberal fasciotomy. Another group from 2008 onwards had undergone primary liberal fasciotomy in all the 45 patients (Group C).
In group A, we had 5 amputations and one death. In group B, there were no amputations or deaths and from group C, we had one amputation and no deaths.
Blunt and distal traumatic vascular injury of the extremities and its repair should always combined with primary liberal fasciotomy, which although increases manageable morbidity, avoids disability (functional as well as anatomical).
血管损伤在所有损伤中占比不到1%，但其严重并发症值得特别关注。截肢或保留疼痛且无功能的肢体是严重血管损伤或治疗不当最不利的后果。因此，血管损伤需要明智且多维度的处理方法。
本回顾性研究旨在评估对肢体筋膜切开术方法进行微小调整的结果，使其在切口和定义方面更加宽松。
2008年的55例患者中，45例患者（A组）未进行筋膜切开术或仅进行了有限的一期筋膜切开术，10例患者（B组）进行了一期宽松筋膜切开术。从2008年起的另一组45例患者均接受了一期宽松筋膜切开术（C组）。
A组有5例截肢和1例死亡。B组无截肢或死亡情况，C组有1例截肢且无死亡。
四肢钝性和远端创伤性血管损伤及其修复应始终结合一期宽松筋膜切开术，这虽然会增加可处理的发病率，但可避免残疾（功能和解剖方面）。
