gms | German Medical Science

10th Munich Vascular Conference

01.-03.12.2021, online

Characteristic of the main vessels’ injuries of the lower extremities during joint forces operation in 2014–2019

Meeting Abstract

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10th Munich Vascular Conference. sine loco [digital], 01.-03.12.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. Doc32

doi: 10.3205/21mac32, urn:nbn:de:0183-21mac324

Published: December 22, 2021

© 2021 Nahaliuk et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Background: Gunshot wounds (GSW) of the main vessels remain relevant and sophisticated sphere of vascular surgery both in therapeutic and organizational way. The purpose of the study is to analyse the character of the injuries, localization, concomitant trauma, results of treatment, and clinical outcomes in patients with injuries of the main vessels of the lower extremities during Joint Forces Operation (JFO) in the period from 2014 to 2019.

Methods: There were analysed 51 cases of GSW of the main vessels of the lower extremities. The inclusion criteria were military servicemen of the Armed Forces of Ukraine; patients with non-lethal injuries; patients who required intervention on the main vessels; males. The exclusion criteria involved all civilians with vascular injury; lethal cases registered before evacuation on the stage of qualified vascular surgical assistance; females.

Results: The biggest amount of injuries of the main vessels were registered in 2014 (29.4 % form all injuries), the smallest – in 2017 and 2019 (5.9% accordingly).The analysis of the age category showed: 9.8% – patients under 20 years old; 37.3% – from 21 to 30 years old; 29.4% – from 31 to 40 years old; 19.6% – from 41 to 50 years old; 3.9% – older than 50 years old. Among all injuries, 88.2% were combat injuries, and 11.8% – non-combat. 39.2% of all injuries involved damage of the artery, and 60.8% – both artery and vein. The localisation of the GSW was the following: 76.5% of the injuries were in femoropopliteal area, 21.6% – peroneal area, 1.9% – both. The injuries that accompanied the trauma of the main vessels included: bone injury (37.3%), bone and nerve injury (25.5%), nerve injury (23.5%), isolated soft tissue injury (13.7%).The injury of both lower or upper extremities occurred in 25.5%, organs of thoracic cavity in 3.9%, organs of abdominal cavity – in 3.9%, head and neck injury – in 2%, injury of 3 and more anatomical areas – in 17.6%, isolated trauma – in 47.1%. In 51 combatants there were performed 513 surgeries: 77 (15%) on the main vessels, 14 (2.7%) amputations and re-amputations, 422 (82.3%) – others. In 74.5% of patients the results of treatment were satisfactory, in 25.5% there was performed an amputation of the lower extremity. The results of the long-term outcomes are presented in Figure 1 [Fig. 1].

Conclusion: For the effective and adequate medical assistance to the injured combatants it is necessary to create thorough algorithm of specialized treatment of patients with described type of trauma in high-qualified medical institutions and rehabilitation centres which will be aimed at rescue from death from acute haemorrhage, prevention of severe disability and management of complications and clinical outcomes of the vascular trauma on all stages of medical evacuation.