Robbs J V, Baker L W
J Trauma. 1978 May;18(5):324-8. doi: 10.1097/00005373-197805000-00005.
Experience with 105 lower limb arterial injuries in 103 patients in a general hospital is described. The pathology is discussed: it is noted that spasm per se could not be incriminated as a cause of ischemia. Management of the injuries and associated fractures is outlined. A plea is made for use of external fixation in compound injuries. An aggressive approach to the degloved limb, open three-compartment fasiotomy for severe vascular injury with signs of ischemia, and delayed primary closure for wounds with septic complications are recommended. Associated soft-tissue injury requires arterial reconstruction even in the presence of muscle rigor and anesthesia.
描述了一家综合医院103例患者中105处下肢动脉损伤的经验。对病理情况进行了讨论:指出痉挛本身不能被认定为缺血的原因。概述了损伤及相关骨折的处理方法。呼吁在复合伤中使用外固定。建议对脱套伤采取积极的处理方法,对伴有缺血迹象的严重血管损伤行开放性三间隙筋膜切开术,对有脓毒症并发症的伤口行延迟一期缝合。即使存在肌肉强直和麻醉,相关的软组织损伤也需要进行动脉重建。