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Vascular trauma

Vascular trauma. Hassan Ravari MD Associated Professor of Vascular Surgery Mashhad-Imam Reza Hospital Department of vascular surgery. Vascular trauma. The amputation rate 50% during World War II 2% At present time. Mechanism:. Penetrating Blunt Iatrogenic. Stab Gunshot

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Vascular trauma

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  1. Vascular trauma • Hassan Ravari MD • Associated Professor of Vascular Surgery • Mashhad-Imam Reza Hospital • Department of vascular surgery

  2. Vascular trauma The amputation rate • 50% during World War II • 2% At present time

  3. Mechanism: • Penetrating • Blunt • Iatrogenic Stab Gunshot Shotgun

  4. Assosciated injury: • 1st rib Fx • Scapular Fx • Sternal Fx

  5. Knee dislocation: 23% Vascular injury

  6. Iatrogenic: • Catheterization • Intraoperative Liver surgery Biliary surgery Pancreatic surgery

  7. Vascular trauma( Extremity )

  8. Vascular trauma (Dx) Hard signs Soft signs

  9. Vascular trauma (Dx) Hard signs : Pulsatile bleeding Expanding hematoma Pulsatile hematoma Limb ischemia ( 5 P ) Thrill or Bruit Operation

  10. 1-Pain 2-Pallor 5,P 3-Paresthesias 4-Pulselessness 5-Paralysis

  11. Vascular trauma (Dx) Softsigns : Minor bleeding Small hematoma Proximity Assosciated nerve inj. Unexplained shock Evaluation

  12. Vascular trauma (Dx)Capillary refillPulse deficit

  13. Capillary refill time < 2 sec Good < 3 sec Acceptable > 3 sec Prolonged

  14. Vascular trauma Evaluation Arteriography ( Gold standard ) Duplex

  15. Doppler ultrasound

  16. Blunt vascular trauma Capillary refillPulse deficit Arteriography

  17. Vascular trauma (Rx) Control of external bleeding Direct pressure

  18. Hemostasis Direct pressure

  19. Arterial Bleeding

  20. Tourniquet > 5cm wide Systolic BP Time

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