Torres SNA, Torres SA

Language: Spanish
References: 47
Page: 136-146
PDF size: 455.65 Kb.

ABSTRACT

Background: The vascular injuries continue being the main cause mortality in the armed conflicts and in the confront face between the civil population, the increasing a major degree of violence between the young persons added to a high consumption of drugs and alcohol in the countries of the third world, the vascular surgeons will face major medical challenges in patients more serious vascular injuries and in occasions of multiple vessels, but the above mentioned injuries can be masked in the patients by multiple trauma since they can appear as hidden hemorrhage or isquemia late, not to detect in time the above mentioned injuries in the polytraumatized patients can leave the patients who survive with a severe disability.
Material and methods: A retrospective study was realized, observational and longitudinally, from June 2007 to June 2010 in 38 patients who were admission polytraumatized to the urgent rooms and were into rooms the hospital, of Irapuato’s General Hospital of the Secretary of Health of Guanajuato, Mexico and in whom vascular injuries were detected too after being they submitted to surgery for revascularization, were valued the survival of the patients and their sequels of disability. Furthermore a new revision was performed about the news strategic for treatment this injuries.
Results: They were 38 patients: 4 women (10.5%) and 34 men (89.47%) range of age of the patients of 13-71 years with an average of 29.8 years old with proportion between the men and women of 9:1, the mechanism of major injury in the patients poliytraumatized were for weapon sharp 16 (42.10%), only 30 (78.94%) the patients presented degree of shock hipovolemic degree I ‹ 750 mL: 5 patients; degree IInd 750-1,500 mL: 4 patients; degree IIIrd 1,500-2,000 mL: 13; degree IVth › 2,000 mL: 8. Medical precedents before the traumatism the alcoholism 13 (34.2 %) was the most frequent, the patients with obvious signs of vascular injury to the new patient were 30 (78.9 %) and with suggestive signs 8 (21 %), were a total of 56 vascular injuries since there were patients with mixed injuries, being of these arterial 32 (57.14. %) and of venous injuries 24 (42.85 %), the vascular injuries detected the majority of the cases to themselves clinical and Doppler portable in 100% cases, a time detection that was ranging of less than 1 hr-less than 15 day, the most frequent arterial revascularization was for the suturing end-end anastomosis 11 (34.37%) and the venous procedure of repair was lateral suture technique 12 (50%), they were a total of 14 thrombectomies (25%) in 56 injuries, the injury more frequent accompanist in the patients they were the fractures of extremities that they presented in 23 cases (60.5%), the surgical time ranged of 1.5-8 hrs with an average of 3.8 hrs, the mortality of the patients were 3 patients (7.89%), 4 patients had finally moderate disability (10.52%) and 3 patients severe disability (7.8%).
Conclusion: To have in the medical services of urgencies and hospitalization the news strategics to handle the patients polytraumatized with vascular injuries will diminish the mortality and the sequels of these injuries.

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