Advancing Surgical Outcomes in Extremity Vascular Trauma: Insights from Clinical Experience

Atilla Orhan; Mücahit Tahsin Demirtaş

Makale detayları

Advancing Surgical Outcomes in Extremity Vascular Trauma: Insights from Clinical Experience

Yazarlar:

Atilla Orhan | Mücahit Tahsin Demirtaş

Yayıncı:

Selcuk University

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer)

Dergi:

Genel Tıp Dergisi Vol.35 Issue 1, pp.174-180

Belge Tipi:

Makale

Yayın Tarihi:

2/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001339647

pISSN:

2602-3741

Anahtar kelimeler:

Özet:

 Abstract Background: Extremity trauma is a major contributor to global morbidity and mortality, comprising up to 70 of trauma admissions. Vascular injuries associated with extremity trauma pose significant challenges, as delays in diagnosis may lead to acute limb ischemia, compartment syndrome, and limb loss. Timely diagnosis and surgical intervention are essential for optimizing patient outcomes. Methods: This retrospective cohort study analyzed 85 patients with vascular extremity trauma treated at a tertiary care hospital from 2018 to 2023. Patients with isolated soft tissue injuries or chronic injuries were excluded. Data on demographics, injury mechanisms, clinical presentations, diagnostic imaging, surgical interventions, and outcomes were collected. Primary outcomes included limb salvage and mortality rates, while secondary outcomes evaluated complications and functional recovery. Results: The cohort had a mean age of 33.7 years, with a predominance of male patients 87.1. Lower extremity injuries were the most common, with gunshot wounds as the leading cause 31.8. Most 90.6 presented within 6 hours of injury, and 55.3 exhibited hemodynamic instability. In 91.8 of cases, surgical intervention was required, predominantly involving interposition vein grafting and primary repairs. Limb salvage was achieved in 92.9 of patients, though 15.3 experienced complications, primarily ischemia and necrosis. The rate of iatrogenic trauma was significantly higher in hemodynamically stable patients 18.4 vs. 4.3, p0.007. Conclusion: Early surgical intervention in extremity trauma is crucial for high limb salvage rates and favorable outcomes. Despite a notable complication rate, timely management can mitigate adverse effects. Future studies should focus on improving long-term functional outcomes and developing comprehensive rehabilitation protocols tailored to extremity trauma patients.

 Abstract Background: Extremity trauma is a major contributor to global morbidity and mortality, comprising up to 70 of trauma admissions. Vascular injuries associated with extremity trauma pose significant challenges, as delays in diagnosis may lead to acute limb ischemia, compartment syndrome, and limb loss. Timely diagnosis and surgical intervention are essential for optimizing patient outcomes. Methods: This retrospective cohort study analyzed 85 patients with vascular extremity trauma treated at a tertiary care hospital from 2018 to 2023. Patients with isolated soft tissue injuries or chronic injuries were excluded. Data on demographics, injury mechanisms, clinical presentations, diagnostic imaging, surgical interventions, and outcomes were collected. Primary outcomes included limb salvage and mortality rates, while secondary outcomes evaluated complications and functional recovery. Results: The cohort had a mean age of 33.7 years, with a predominance of male patients 87.1. Lower extremity injuries were the most common, with gunshot wounds as the leading cause 31.8. Most 90.6 presented within 6 hours of injury, and 55.3 exhibited hemodynamic instability. In 91.8 of cases, surgical intervention was required, predominantly involving interposition vein grafting and primary repairs. Limb salvage was achieved in 92.9 of patients, though 15.3 experienced complications, primarily ischemia and necrosis. The rate of iatrogenic trauma was significantly higher in hemodynamically stable patients 18.4 vs. 4.3, p0.007. Conclusion: Early surgical intervention in extremity trauma is crucial for high limb salvage rates and favorable outcomes. Despite a notable complication rate, timely management can mitigate adverse effects. Future studies should focus on improving long-term functional outcomes and developing comprehensive rehabilitation protocols tailored to extremity trauma patients.

 Abstract Background: Extremity trauma is a major contributor to global morbidity and mortality, comprising up to 70 of trauma admissions. Vascular injuries associated with extremity trauma pose significant challenges, as delays in diagnosis may lead to acute limb ischemia, compartment syndrome, and limb loss. Timely diagnosis and surgical intervention are essential for optimizing patient outcomes. Methods: This retrospective cohort study analyzed 85 patients with vascular extremity trauma treated at a tertiary care hospital from 2018 to 2023. Patients with isolated soft tissue injuries or chronic injuries were excluded. Data on demographics, injury mechanisms, clinical presentations, diagnostic imaging, surgical interventions, and outcomes were collected. Primary outcomes included limb salvage and mortality rates, while secondary outcomes evaluated complications and functional recovery. Results: The cohort had a mean age of 33.7 years, with a predominance of male patients 87.1. Lower extremity injuries were the most common, with gunshot wounds as the leading cause 31.8. Most 90.6 presented within 6 hours of injury, and 55.3 exhibited hemodynamic instability. In 91.8 of cases, surgical intervention was required, predominantly involving interposition vein grafting and primary repairs. Limb salvage was achieved in 92.9 of patients, though 15.3 experienced complications, primarily ischemia and necrosis. The rate of iatrogenic trauma was significantly higher in hemodynamically stable patients 18.4 vs. 4.3, p0.007. Conclusion: Early surgical intervention in extremity trauma is crucial for high limb salvage rates and favorable outcomes. Despite a notable complication rate, timely management can mitigate adverse effects. Future studies should focus on improving long-term functional outcomes and developing comprehensive rehabilitation protocols tailored to extremity trauma patients.

 Özet Giriş Ekstremite travmaları, travma kaynaklı morbidite ve mortalitenin önemli bir nedeni olup, tüm travma yatışlarının 70ine kadarını oluşturabilmektedir. Ekstremite travmalarına eşlik eden vasküler yaralanmalar, akut ekstremite iskemisi, kompartman sendromu ve uzuv kaybı gibi ciddi komplikasyonlara yol açabileceğinden dolayı önemli zorluklar teşkil etmektedir. Bu nedenle, tanının hızlı bir şekilde konulması ve cerrahi müdahalenin zamanında gerçekleştirilmesi hasta sonuçlarının iyileştirilmesinde hayati öneme sahiptir. Yöntem Bu retrospektif kohort çalışmasında, 2018-2023 yılları arasında bir üçüncü basamak hastanede vasküler ekstremite travması nedeniyle tedavi gören 85 hasta incelenmiştir. İzole yumuşak doku yaralanması veya kronik yaralanması olan hastalar çalışmaya dahil edilmemiştir. Demografik veriler, yaralanma mekanizmaları, klinik bulgular, görüntüleme yöntemleri, cerrahi müdahaleler ve sonuçlar gibi veriler toplanmıştır. Birincil sonuçlar arasında uzuv kurtarma ve mortalite oranları yer alırken, ikincil sonuçlar komplikasyonlar ve fonksiyonel iyileşme değerlendirilmiştir. Bulgular Kohortun ortalama yaşı 33,7 olup, hastaların 87,1i erkekti. En sık karşılaşılan yaralanma alt ekstremite yaralanmaları olup, travmaların 31,8i ateşli silah yaralanmalarıydı. Hastaların 90,6sı travmadan sonraki ilk 6 saat içinde başvurmuş ve 55,3ünde hemodinamik instabilite tespit edilmiştir. Olguların 91,8inde cerrahi müdahale gerekli olmuş, en sık kullanılan yöntemler interpozisyon ven grefti ve primer onarımlar olmuştur. Uzuv kurtarma oranı 92,9 olarak bulunurken, hastaların 15,3ünde iskemik ve nekrotik komplikasyonlar tespit edilmiştir. Hemodinamik olarak stabil hastalarda iyatrojenik travma oranı anlamlı derecede yüksek bulunmuştur 18,4e karşı 4,3, p0,007. Sonuç Ekstremite travmalarında erken cerrahi müdahale, yüksek uzuv kurtarma oranları ve olumlu sonuçlar için kritik öneme sahiptir. Önemli bir komplikasyon oranı görülmesine rağmen, zamanında yönetim olumsuz etkileri azaltabilmektedir. Gelecekteki çalışmalar, uzun dönem fonksiyonel sonuçları iyileştirme ve ekstremite travmalarına yönelik kapsamlı rehabilitasyon protokolleri geliştirme üzerinde yoğunlaşmalıdır.

Makale detayları

Advancing Surgical Outcomes in Extremity Vascular Trauma: Insights from Clinical Experience

Yazarlar:

Atilla Orhan | Mücahit Tahsin Demirtaş

Yayıncı:

Selcuk University

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer)

Dergi:

Genel Tıp Dergisi Vol.35 Issue 1, pp.174-180

Belge Tipi:

Makale

Yayın Tarihi:

2/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001339647

pISSN:

2602-3741

Extremity Trauma

Vascular Injury

Limb Salvage

Trauma ManagementEkstremite travmaları

Damar yaralanması

Ekstremite kurtarılması

Travma Yönetimi

Sayı

Makale detayları

Yazarlar: Atilla Orhan | Mücahit Tahsin Demirtaş

Yayıncı: Selcuk University

Ana Başlıklar: Klinik Tıp Bilimleri (Diğer)

Dergi: Genel Tıp Dergisi Vol.35 Issue 1, pp.174-180

Belge Tipi: Makale

Yayın Tarihi: 2/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001339647

pISSN: 2602-3741

Sayı

Yazarlar:

Atilla Orhan | Mücahit Tahsin Demirtaş

Yayıncı:

Selcuk University

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer)

Dergi:

Genel Tıp Dergisi Vol.35 Issue 1, pp.174-180

Belge Tipi:

Makale

Yayın Tarihi:

2/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001339647

pISSN:

2602-3741