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CURRENT Diagnosis & Treatment: Surgery, 13e
Vascular Injuries
Sections: Historical Perspective, The Epidemiology of Vascular Trauma, Types of Injuries, Penetrating Trauma, Blunt Trauma, Clinical Findings, Hemorrhage, Ischemia, False Aneurysm, Arteriovenous Fistula, Diagnosis, Management, Initial Treatment, Nonoperative Treatment, Operative Treatment, Venous Injuries, Fasciotomy, Immediate Amputation.
Topics Discussed: accidents, traffic; amputation; aortic rupture; arterial injury; arterial ischemia; arteriography; arteriovenous fistula; false aneurysm; fasciotomy; gunshot wounds; hemorrhage; nonpenetrating wounds; reconstructive surgical procedures; vein, injury of; wounds and injuries; wounds, penetrating.
Excerpt:
"Much of our knowledge of blood vessel injuries was developed
during the course of military conflicts in the 20th century. Although
techniques for the management of vascular injuries were in use prior
to World War I, arterial ligation to save a life rather than arterial
repair to salvage a limb was generally employed, and amputation
frequently resulted after vascular injury.The local and regional effects of penetrating wounds are determined
by the mechanism of vessel injury. Stab wounds, low-velocity (<
2000 ft/s) bullet wounds, iatrogenic injuries from percutaneous
catheterization, and inadvertent intra-arterial injection of drugs
produce less soft tissue injury and disrupt collateral circulation
less than injuries from sources with greater kinetic energy. The high-velocity
missiles responsible for war wounds produce more extensive vascular
injuries, which involve massive destruction and contamination of
surrounding tissues. The temporary cavitational effect of high-velocity
missiles causes additional trauma to the ends of severed arteries
and may produce arterial thrombosis due to disrupted intima..."
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