Peripheral Vascular Injuries in a Thai Northern Tertiary University Based Trauma Center Level I between 2007 - 2011

Authors

  • Kaweesak Chittawatanara Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Kritsada Phruksawatnon Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Narain Chotirosniramit Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Kamtone Chadacham Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Tidarat Jirapongcharoenlap Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Keywords:

Amputation, fasciotomy, Mangled Extremity Severity Score, peripheral vascular injury, popliteal artery injury

Abstract

Background: Peripheral vascular injury (PVI) is commonly associated with major trauma especially orthopedics
injury. However, detailed descriptive data in Thailand especially in the Northern region were not available.
Objective: To describe the PVI over a five-year experience in our institute between 2007 and 2011after trauma
team was organized.
Methods: All of the PVI records during January 2007 - September 2011 were retrieved from the hospital
database. Injury characteristics, time to surgery, severity scoring and operation types were recorded and analyzed.
Results: A total of 176 injured patients were included in this study. The median occurrence of injury was 35 cases
per year (range 23 - 51 cases). Male was predominant gender (87.5%). Median age (Interquartile range, IQR) was 30
(21 - 43) years. Lower extrimity PVI was occurred higher than upper extremities PVI (59.1% vs. 40.9%). The most
common injury sites of upper extremity and lower extremity were radial arteries (12.5%) and popliteal arteries (26.7%)
respectively. Of these, 47% underwent vascular repair with conduits (44.3% with reverse saphenous vein graft (RSVG),
2.8% with synthetic PTFE graft) and 29% were repaired without conduit. The amputation rate was 15.3% with median
(IQR) of Mangled Extremity Severity Score (MESS) was 7 (7-8) and significant higher than non amputation group
(p<0.001). Fasciotomy rate was 6.8%. Significant risk factors of amputation were female (p=0.013), MESS score
(p<0.001), skeletal and soft tissue score (p<0.001), limb ischemic score (p<0.001), shock score (p<0.001), lower
extremity injury (p=0.014), blunt injury (p=0.011), popliteal artery injury (p=0.018), associated nerve (p=0.006), and
associated bone injury (p=0.015).
Conclusion: PVI is frequently found injury in the Northern Tertiary University-based hospital. Lower extremity
PVI occurred higher than upper extremity PVI. Female gender, MESS score and its components, blunt injury type, sites
of injury of lower extremity and popliteal, associated nerve and bone injuries were associated with the risk of
amputation.

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vol35no2

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Published

2014-06-30

How to Cite

1.
Chittawatanara K, Phruksawatnon K, Chotirosniramit N, Chadacham K, Jirapongcharoenlap T. Peripheral Vascular Injuries in a Thai Northern Tertiary University Based Trauma Center Level I between 2007 - 2011. Thai J Surg [Internet]. 2014 Jun. 30 [cited 2024 Dec. 23];35(2). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/226391

Issue

Vol. 35 No. 2 (2014): April - June

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.