Traumatic Peripheral Arterial Injury with Open Repair: A 10-Year Single-Institutional Analysis

Abstract

Background: We report our 10-year experience with traumatic peripheral arterial injury repair at an urban level I trauma center.Methods: Between January 2007 and December 2016, 28 adult trauma patients pre-sented with traumatic peripheral arterial injuries. Data were retrospectively collected on demographic characteristics, the mechanism of injury, the type of vascular injury, and physiological status on initial assessment. The analysis also included the Mangled Extremi-ty Severity Score (MESS), Injury Severity Score, surgical procedures, and outcome variables including limb salvage, hospital stay, intensive care unit stay, and postoperative vascular complications.Results: Four (14.3%) patients required amputation due to failed revascularization. MESS significantly differed between patients with blunt and penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005). The amputation rate was not significantly different be-tween patients with blunt and penetrating trauma (20% vs. 0%, respectively; p=0.295). The overall mortality rate was 3.6% (1 patient).Conclusion: Blunt trauma was associated with higher MESS than penetrating trauma, and amputation was more frequent. In particular, patients with blunt trauma had signifi-cantly higher MESS than patients with penetrating trauma (8.2±2.2 vs. 5.8±1.3, respec-tively; p=0.005), and amputation was performed when revascularization failed in cases of blunt trauma of the lower extremity. Therefore, particular care is needed in making treat-ment decisions for patients with peripheral arterial injuries caused by blunt trauma.

Keywords

• blunt trauma
• penetrating trauma
• arteries
• revascularization