Mumtaz Ahmad Khan, Shabana Jamal, Tanwir Khaliq.
A critical appraisal of management of extremity vascular trauma in civilian population: a PIMS experience.
Rawal Med J Jan ;36(3):190-4.

Objectives: To study demography, etiology and spectrum of civilian vascular trauma and its outcome especially in terms of amputation rate in relation to ischemia time. Patients and Methods: All patients presenting with vascular injury from January 1, 2004 to December 31, 2009, were included in the study. Patients with late presentation secondary to complications like aneurysm and arteriovenous fistula were excluded from the study. All data were analyzed using SPSS 17. Results: During the study period, 89 patients presented with vascular trauma. Majority of patients were male (n-64, 71.91%). Mean age was 36.44 years. Mean injury to revascularization time was 6.9 hours. Firearm was the most common etiological factor (n-62, 69.7%). Common femoral artery was most commonly involved vessel. Amputation rate in patients operated during first six hours was 9.75% (n-41) rising to 22.22% (n-4) in patients revascularized in 6-1 2 hours period and 61.53% (n-16) after 12 hours. Mean hospital stay was 22.58 days. Conclusions: Amputation rate rises with increasing ischemia time. Vascular trauma needs prompt recognition and early revascularization. There is need to train surgeons at district level hospitals in vascular trauma management.

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