5. Vascular Trauma
Signs of vessel injury
• Hard signs
• Soft sign
Hard signs
– Active bleeding
– Signs of distal ischaemia
– Expanding hematoma
– Thrills, Bruits
6. Signs of a vessel injury
• Soft signs
– Hematoma
– Injury close to a known neurovascular bundle
– Reduced pulse
• In limbs;
– Paresis and Paresthesia - Viability threatened
– Anaethesia and paralysis - Not viable.
10. Principles of management
• Resuscitate
• Assess viability and extent of injury
• Repair as soon as possible
– + / - EF
– +/ - fasciotomy
• Post intervention monitoring
• Rehabilitation
11. Surgical Repair
• General Anesthesia
• Clean the Entire Limb
• Prepare Opposite Thigh – For Vein Graft
12. Surgical Repair (Cont..)
• Control of proximal and distal ends and trimming
• Thrombectomy
• Interposition graft / Direct approximation
– Unit experience – 88.2% RSVG
• Prosthesis
– Lower patency
– Infection
13.
14.
15.
16. Surgical Repair (Cont..)
• Wound debridement
• Control of proximal and distal ends and trimming
• Thrombectomy
• Interposition Graft / Direct Approximation
– Unit Experience – 88.2% RSVG
• Prosthesis
– Lower Patency
– Infection
18. Combined Vascular and Skeletal
Trauma
– Revascularization / Fixation (External Fixator – EF)
• Bone fixation first if limb is not threatened
• Apply EF antero - laterally
• Revascularisation first if limb is threatened
20. Principles of management
• Resuscitate
• Assess viability and extent of injury
• Repair as soon as possible
– + / - Fasciotomy
– + / - EF
• Post Intervention Monitoring
• Rehabilitation