Management Of Lower Limb Vascular Injuries in Ghazi Al Hariri Teaching Hospital/Baghdad 2015

Abstract

Background:lower limb vascular injuries are encountered in a vast number of settings, ranging from blast, bullet , stab wounds injuries, to causes as small as blood sampling procedures. Surgery for vascular repair is sometimes indicated without angiography. Broadly speaking, options for repair after assessment of vasculature include simple vessel wall repair, venous patching, resection with end-to-end anastomosis or with inter-positioning graft, bypass graft, ligation or amputation. Aim: The general objective of this study is to identify the etiology, presentations, management and outcome of lower limb vascular injuries in Ghazi Al Hariri hospital, Baghdad, Iraq, from 1st  January 2015 to 31st December 2015. Patients and Methods: The study design was retrospective hospital based study and the study population included all patients who referred to the vascular surgery consultation clinic in Ghazi Al Hariri Hospital and to emergency department. Ninety patients had lower limb vascular injuries. Data collected using structured checklist and analyzed. Results:Eighty-five (94.5%) were males and five (5.5%) were females. The most common age at presentation was 21–30 years (50%), followed by 31–40 (24.4%). Blast penetrating shell injuries were the highest cause for lower limb vascular injury with incidence rate of 50%, while second cause is bullet penetrating injuries presented at 40%. Most common artery injured was the popliteal artery (40 patients; 44.4%) followed by the femoral artery (29 patients; 32.3%). Limb salvage rate was 85% and mortality rate was 7.8%. Conclusions: Our results revealed that blast injuries are the most frequent cause of lower extremity vascular injuries in Ghazi Al Hariri hospital at the period of our study. Appropriate intervention and rapid restoration of blood flow is crucial to have a good outcome and is the key to successfully salvage the injured limb. Amputation rate was the highest in patients with popliteal artery injuries.