The effects of Time Interval on Vascular Trauma

This study composes of 269 patients, 98 cases military trauma and 271 cases non-military or civilian trauma. In the 50 percent of military cases the interval between trauma and surgical procedure was less than 8 hours. In this condition because of surgical failure for 3 cases limb amputation were performed and in the remaining cases the results of surgery were succesful. In 18 cases (2.8%) where interval was between 8-12 hours, in 8 cases amputation were performed and finally in the remaining cases by debridement of muscle necrosis, the limb were salvaged. The results of surgical procedure in order to limb salvage were satisfactory. In about 25.15 percent of cases, the interval between trauma and surgical procedure was over 8 hours, in which 10 patients under go amputation and in the remaining by fasciotomy and debridement the limbs salvaged but with some sensory and motor disturbance. In conclusion, the indications for arlerial repair after 8 hours from trauma are as follow absence of extensive skin necrosis, normal kidney function, absence of fracture or muscle necrosis in site of arterial injury, presence of adequate soft tissue for coverage of arterial graft or repair, and absence of air in tissue or crepitating. In absence of these indications, limb salvage will be failure and amputation should be performed with out delay