Reassessment of the role of routine operative exploration in vascular trauma

Kenneth R. Sirinek, Barry A. Levine, Harold V. Gaskill, H. David Root

Research output: Contribution to journalArticle

66 Scopus citations

Abstract

During the 5-year period ending December 1978, 390 patients were explored for suspected vascular injury either in the neck or in one of the extremities with 13% morbidity and a 1% mortality rate. Positive exploration for vascular injury in 139 patients (36%) resulted in 28% morbidity and 2% mortality. Negative exploration in 251 patients (64%) was associated with a 5% morbidity and 0.4% mortality. Per cent positive exploration by type of injury was: iatrogenic injury (100%), foreign body laceration (100%), blunt trauma (79%), stab wound (32%), and gunshot wound (31%). Per cent positive exploration by area was: brachium (68%), popliteal area (63%), femoral area (28%), axilla (27%), and neck (25%). Routine exploration of patients at risk for vascular injury can be accomplished with minimal morbidity and mortality but is associated with a low (36%) diagnostic yield. 'Exclusion’ arteriography in hemodynamically stable patients with equivocal signs of vascular injury appears to be indicated to increase diagnostic accuracy.

Original languageEnglish (US)
Pages (from-to)339-344
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume21
Issue number5
DOIs
StatePublished - May 1981

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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