Acil vasküler yaralanmalar: Hasta profili, yönetim stratejileri ve mortalite risk faktörleri

Amaç: Bu çalışmada yaralanmanın mekanizmaları ve yerleri, tanı, hasta profili, tedavi yöntemleri ve mortalite risk faktörleri değerlendirildi ve acil vasküler yaralanmaların tedavisine yönelik damar cerrahları için bir rehber sunuldu. Çalışma planı: Eylül 2009 - Haziran 2013 tarihleri arasında toplam 161 hasta (156 erkek, 5 kadın; ort. yaş: 30.3±11.8 yıl; dağılım 8-80 yıl) vasküler yaralanma nedeniyle cerrahi olarak kliniğimizde tedavi edildi. Hastaların tümü klinik değerlendirme sonrası acil olarak veya Doppler ultrason, bilgisayarlı tomografi anjiyografi veya manyetik rezonans anjiyografi gibi tanısal görüntüleme sonrası ameliyata alındı. Bulgular: Delici yaralanmalar (%89.4) daha sık olup, yaralanmaların büyük bir çoğunluğu üst ekstremite (%49.1) takiben alt ekstremiteyi (%41), batını (%5.6), boynu (%2.5) ve toraksı (%1.9) içermekteydi. Küçük damar yaralanmalarında basit bağlama tekniği kullanılırken (%14.3), daha karmaşık durumlarda uç uca anastomoz (%49.7) ve safen ven (%32.3) veya protez greft (%4.3) ile onarım yapıldı. On hastada (%6.2) mortalite gözlendi. Mortalite için majör risk faktörleri; yaralanmanın batını içermesi (p

Emergency vascular injuries: patient profile, management strategies and risk factors for mortality

Background: This study aims to evaluate the mechanisms and localizations of injury, diagnosis, patient profile, treatment modalities, and risk factors for mortality, and to offer a guide for vascularsurgeons for the management of emergency vascular injuries. Methods: Between September 2009 and June 2013, a total of161 patients (156 males, 5 females; mean age 30.3±11.8 years; range 8 to 80 years) were surgically treated for vascular injuries in our clinic. All patients were taken to the operation emergently after clinical assessment or after diagnostic imaging using Doppler ultrasound, computed tomography angiography or magnetic resonance angiography.Results: Penetrating injuries (89.4%) were more common and most injuries involved the upper extremity (49.1%), followed by the lower extremity (41%), abdomen (5.6%), neck (2.5%), and thorax (1.9%). Simple ligation technique (14.3%) was used for small vessel injuries, whereas end-to-end anastomosis (49.7%) and repair with a saphenous vein (32.3%) or prosthetic graft (4.3%) was used for more complex cases. Mortality was seen in 10 patients (6.2%). Major risk factors for mortality were abdominal localization of injury (p

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