Factors contributing to morbidity after combined arterial and venous lower extremity trauma

Nathan R. Manley, Louis J. Magnotti, Timothy C. Fabian, Michael B. Cutshall, Martin Croce, John P. Sharpe

Research output: Contribution to journalArticle

Abstract

The purpose of this study was to evaluate the impact of management of venous injury on clinical outcomes in patients with combined lower extremity arterial and venous trauma. Patients with common and external iliac, common and superficial femoral, and popliteal artery injuries were identified. Patients who underwent vein repair and those who received vein ligation were compared. The analysis was repeated for those patients who required secondary intervention for their arterial injury and those who did not require secondary intervention. Seventy patients were identified with both arterial and venous injuries: 40 underwent vein ligation and 30 received vein repair. There was no difference in ischemic time between patients undergoing vein repair compared with ligation. Vein ligation did not produce a higher incidence of muscle debridement (10% vs 15%, P 5 0.72), necessity for secondary intervention (10% vs 7.5%, P 5 0.99), or amputation (3.3% vs 7.5%, P 5 0.63). Patients who required secondary intervention had a greater degree of shock on presentation (packed red blood cells (PRBC), 13 units vs 6 units, P 5 0.02) and were more likely to require muscle debridement (50% vs 9%, P 5 0.02) and amputation (33% vs 3%, P 5 0.03). Vein ligation did not impact muscle ischemia or success of arterial repair in patients with combined venous and arterial trauma in the lower extremities. Patient morbidity after extremity vascular trauma is most related to degree of shock.

Original languageEnglish (US)
Pages (from-to)1217-1222
Number of pages6
JournalAmerican Surgeon
Volume84
Issue number7
StatePublished - Jul 1 2018

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Lower Extremity
Morbidity
Veins
Wounds and Injuries
Ligation
Debridement
Amputation
Muscles
Shock
Popliteal Artery
Femoral Artery
Blood Vessels
Ischemia
Extremities
Erythrocytes
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Manley, N. R., Magnotti, L. J., Fabian, T. C., Cutshall, M. B., Croce, M., & Sharpe, J. P. (2018). Factors contributing to morbidity after combined arterial and venous lower extremity trauma. American Surgeon, 84(7), 1217-1222.

Factors contributing to morbidity after combined arterial and venous lower extremity trauma. / Manley, Nathan R.; Magnotti, Louis J.; Fabian, Timothy C.; Cutshall, Michael B.; Croce, Martin; Sharpe, John P.

In: American Surgeon, Vol. 84, No. 7, 01.07.2018, p. 1217-1222.

Research output: Contribution to journalArticle

Manley, NR, Magnotti, LJ, Fabian, TC, Cutshall, MB, Croce, M & Sharpe, JP 2018, 'Factors contributing to morbidity after combined arterial and venous lower extremity trauma', American Surgeon, vol. 84, no. 7, pp. 1217-1222.
Manley NR, Magnotti LJ, Fabian TC, Cutshall MB, Croce M, Sharpe JP. Factors contributing to morbidity after combined arterial and venous lower extremity trauma. American Surgeon. 2018 Jul 1;84(7):1217-1222.
Manley, Nathan R. ; Magnotti, Louis J. ; Fabian, Timothy C. ; Cutshall, Michael B. ; Croce, Martin ; Sharpe, John P. / Factors contributing to morbidity after combined arterial and venous lower extremity trauma. In: American Surgeon. 2018 ; Vol. 84, No. 7. pp. 1217-1222.
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