Introduction Extremity injuries involving significant trauma to bone, soft tissue, and major vessels are relatively uncommon outside of the wartime setting. This constellation of injuries may also be referred to as the mangled extremity. Much of the difficulty encountered in…
Introduction In the United States, injuries account for approximately 10,000 childhood fatalities every year. Unintentional injury results in one in four pediatric medical visits, and the direct cost of these injuries is estimated to be over $50 billion annually. Vascular…
Introduction In 1949, Jean Kunlin performed the first saphenous vein bypass in the lower extremity of a patient suffering from ischemia. The work was not the result of chance alone as his predecessors in vascular surgery had been working on…
Introduction Since the turn of the century, there have been major changes in the management of the severely injured patient. Perhaps most notable is the adoption of damage control or staged procedures. Stone and colleagues provided the landmark description of…
Introduction and Scope In this chapter we present the workup and surgical management of vascular trauma to the lower extremities spanning from the common femoral vessels in the groin to the tibial vasculature at the ankle. The term “vascular injury”…
Epidemiology of Upper Extremity Vascular Injury Reports from civilian and military settings have shown the distribution and outcomes of major vascular injuries going as far back as the Civil War ( Table 21.1 ). Although some publications comment on and…
Introduction Perhaps no other anatomic region contains so many vital structures in such a compact space as the neck and thoracic outlet. Injuries in this region can result in hemorrhage, stroke, upper and/or lower extremity paralysis, loss of airway, and…
Introduction Injury to the large veins of the abdominal cavity, including the inferior vena cava (IVC) and the portal and the superior mesenteric veins is uncommon occurring in 5% of penetrating and 1% of blunt trauma cases. Because prehospital mortality…
Introduction Major vascular injuries may be seen in up to 25% of abdominal trauma and are associated with a high mortality. Following penetrating abdominal trauma, vascular injuries are the most common causes of death. Intra-abdominal hemorrhage can be catastrophic due…
Introduction The screening, definitive diagnosis, and the method and timing of definitive management of blunt thoracic aortic injuries (BTAI), have undergone revolutionary changes over the last few years. A routine chest CT scan has replaced plain x-rays for screening purposes;…