Reassessment of the Role of Routine Operative Exploration in Vascular Trauma

Publisher Website
Google Scholar
Abstract
During the 5 yr period ending Dec. 1978, 390 patients were explored for suspected vascular injury either in the neck or in 1 extremity with 13% morbidity and a 1% mortality rate. Positive exploration for vascular injury in 139 patients (36%) resulted in 28% morbidity and 2% mortality. Negative exploration in 251 patients (64%) was associated with a 5% morbidity and 0.4% mortality. Percent positive exploration by type of injury was: iatrogenic injury (100%), foreign body laceration (100%), blunt trauma (79%), stab wound (32%) and gunshot wound (31%). Percent positive exploration by area was brachium (68%), popliteal area (63%), femoral area (28%), axilla (27%) and neck (25%). Routine exploration of patients at risk for vascular injury can be accomplished with minimal morbidity and mortality but is associated with a low (36%) diagnostic yield. Exclusion arteriography in hemodynamically stable patients with equivocal signs of vascular injury appears to be indicated to increase diagnostic accuracy.

This publication has 0 references indexed in Scilit: