Background: peripheral vascular wounds/trauma is a severe type of surgical emergency, the increasing rate due to the rapid increase of traffic, labor and living accidents. Subjectives and Method: retrospective study, all patients with peripheral vascular wounds/traumas (alone or combination in multiple trauma) were emergency operated at Viet Duc Hospital from January 2004 to June 2006. Results: A total of 310 patients with peripheral vascular injuries in the study, of which accounted for 62.3% of injury, trauma group accounted for 37.7%. The mean age of 30. In first aid, pressed tape accounted for high rate (71.5%). Rate of popliteal vascular trauma due to fractures around the knee accounted for 65.5%, the rate of brachial vascular trauma with fractures around the elbow was 50%. Rate of late diagnosis of arterial trauma was 14.6%, higher than the arterial wounds (2.6%). The rate of ultrasound for forelimbs - where vessels were many wounds, was lower than that for hindlimbs - where vessels were many traumas (44% vs 67.9%). For vascular wounds, more directly vascular connection and more intervention on veins, whereas, for arterial trauma, more vascular graft. Rate of complications was low (7.4%), with no deaths. Conclusions: Overall, the results of emergency surgery for peripheral vascular wounds/trauma were well. No cases was death from vascular lesions, rate of complications was low.
Blood Vessels/ injuries ; Emergencies ;

PURPOSE: To evaluate the serious effects of a paint gun injury and to determine the proper treatment. MATERIALS AND METHODS: The authors reviewed 30 cases of paint gun injuries of the hand that were treated from March, 1990 to September, 2000. We extended the original wound and removed the paint as soon as possible. The wound was left open, and debridementrepeated and delayed wound closure performed. The authors evaluated the results according to the Strickland evaluation method, and analysedthe results with respect to treatment delay and extent of injury. RESULTS: Delayed treatment, invasion of the paint along the neurovascular bundle and extensive injury resulted in a poor outcome. Amputationwas inevitable in 4 cases in which treatment had been delayed or when blood vessels had been invaded by the paint. CONCLUSION: Paint gun injury should be considered an emergency requiring immediate debridement. The surgeon should warn the patient that even after proper treatment, poor outcome can result.
Blood Vessels ; Debridement ; Emergencies ; Hand Injuries* ; Hand* ; Humans ; Paint ; Wounds and Injuries

In blunt abdominal trauma, the abdomen may be compressed and crushed without disruption of the skin, without external bruising, and yet extensive and fatal internal injuries may be present. The penetrating wounds are especially dangerous because of the possibility of grave injury to internal organs or major blood vessels. The majority are homicidal injuries: suicide by stabbing, or accidental stabbing, is infrequent. The abdominal injuries usually coexist with other-site injuries, especially with chest injuries. The homicide and the suicide often aim at the heart, in consequence wound the left side of the chest or upper abdomen. This review is discussed on the mechanism of the blunt and penetrating abdominal injury, types of injury, and significance of medicolegal aspects of the abdominal trauma.
Abdomen* ; Abdominal Injuries ; Blood Vessels ; Heart ; Homicide ; Skin ; Suicide ; Thoracic Injuries ; Thorax ; Wounds and Injuries ; Wounds, Nonpenetrating* ; Wounds, Penetrating

Electrical injuries can cause cardiac abnormalities, ranging from dysrhythmias to myocardial infarction. Atrial fibrillation after electrical injury is extremely rare. The mechanisms underlying electrical current-induced arrhythmias are unclear. However, due to differences in electrical resistance, current travels preferentially along blood vessels and nerves, making the heart the most susceptible organ to electrical injury. Cardiac arrhythmias may occur at the time of electrical injury or later, but most occur within the first day of injury. Almost all patients described in previous reports with atrial fibrillation developed the condition after high voltage injuries (> 1,000 V). In our case, however, atrial fibrillation developed after a low voltage injury (220 V). Atrial fibrillation was detected and the rate was controlled with intravenous digoxin infusion. A normal sinus rhythm was restored 21 h after the electrical injury.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Blood Vessels ; Digoxin ; Electric Impedance ; Electric Injuries ; Heart ; Humans ; Myocardial Infarction

The chest wall plays a role to protect vital organs in the trunk such as heart and lung, and to facilitate a semi-rigid structure for breathing. When a defect occurs in a chest wall for such reasons as trauma, tumor, infection, inflammation, post-radiation necrosis, congenital anomaly, and so forth, not only anatomical, but also functional aspects should be considered in reconstruction process. It is, generally speaking, difficult to reconstruct a chest wall defect, since these patients tend to be old aged and have underlying disease with chronic and heavily contaminated wounds which had experienced irradiation or operation. In chest wall reconstruction, the authors utilized muscle flaps in trunk to secure a semi-rigid structure, because muscle flaps in trunk are easily accessible, and have reliable blood vessels. We have conducted 42 cases of chest wall reconstruction between Feb, 1996 and Jan, 2003. Except one case, we succeeded in gaining satisfactory results in functional and anatomical aspects. Based on these experiences, we would like to clarify the principles of chest wall reconstruction as below, helping to choose a proper method in the operations. The principles are appropriate debridement, skeletal reconstruction when indicated, coverage of soft tissue with muscle flap and removal of dead spaces.
Blood Vessels ; Debridement ; Heart ; Humans ; Inflammation ; Lung ; Necrosis ; Respiration ; Thoracic Wall* ; Thorax* ; Wounds and Injuries

Preoperative angiography is frequently used in the planning of microsurgical reconstruction for identification of vascular abnormality that influence the planning of operation. But, recently 3D CT angiography is considered as new technique that can provide detailed information about vascular anatomy as well as soft and bony tissue without the risks of invasive angiography. 3D CT angiograms were performed in 19 patients before microsurgical reconstruction for the lower extremity and hand between May of 2003 and Oct of 2004. Sixteen of the studies were of the donor site and all of 19 studies were of the recipient site. No complications were found from the 3D CT angiograms. In one case of the bone exposed open wound, the injury of anterior tibial artery was identified and the zone of injury was adequately demonstrated. With the improvement in quality of CT imaging, 3D CT angiograms may provide a favorable alternative to invasive angiography. It is capable of providing high-resolution, three dimensional vascular imaging without the need for arterial puncture and prolonged post-procedure observation. The relation among blood vessels, bones, and soft tissue is well demonstrated in 3D CT angiogram. Also The acquisition time and examination cost were considerably lower in comparison with invasive angiography. In conclusion, this study demonstrates that 3D CT angiography may provide accurate, safe, and cost-effective preoperative imaging. The 3D CT angiography with relatively low morbidity, low cost, ease of image acquisition can have an broader role in microsurgical reconstructive surgery.
Angiography* ; Blood Vessels ; Hand ; Humans ; Lower Extremity ; Punctures ; Tibial Arteries ; Tissue Donors ; Wounds and Injuries

Blood Vessels ; injuries ; Humans ; Iatrogenic Disease ; prevention & control ; Vascular Diseases ; etiology ; prevention & control

This report presents a clinical case of trauma due to assault with a knife, and describes the importance of using the correct imaging modality in cases of facial penetrating trauma involving the superficial and deep anatomical planes. Penetrating wounds in the maxillofacial region are rare and poorly reported, but can result in serious complications that are difficult to resolve and may compromise the patient's quality of life, especially when large blood vessels or other vital structures are involved. Thus, it is essential to determine the extent of the affected blood vessels and the proximity of the retained object to the anatomical structures. In this case, digital subtraction angiography was the imaging modality chosen. The use of appropriate imaging examinations allows a proper map of the surgical field, reducing the chances of vascular damage during the surgical procedure.
Angiography, Digital Subtraction ; Blood Vessels ; Maxillofacial Injuries ; Quality of Life ; Wounds, Penetrating

BACKGROUND: Most tendon injuries are occurring from a gradual wearing and tearing of the tendon tissues from overuse. Such injuries are usually seen in sports, exercising, or daily activities that involve a high mechanical load and weight bearing. However, owing to the lack of both cellularity and blood vessels in tendons, the process of tendon repair is slow and inefficient. Although various conservative (non-surgical) and surgical management options are conducted by the clinicians, a gold standard of these approaches does not exist. In this regard, the treatment of tendon injuries is challenging. METHODS: Here, we describe the recent advances of biomaterial-based approaches for the treatment of injured tendons. RESULTS: Regenerative medicine is an emerging multidisciplinary research that specializes in the repair of damaged tendon tissues through the delivery of regenerative factors by biomaterials. CONCLUSION: Although current biomaterial-based treatment strategies have shown their potential for tendon healing, future research and clinical applications should focused on finding the optimum combinations of regenerative factors with ideal biomaterials for the repair of tendons.
Biocompatible Materials ; Blood Vessels ; Regenerative Medicine ; Sports ; Tears ; Tendon Injuries ; Tendons ; Weight-Bearing

OBJECTIVETo study the clinical significance of MESS scoring system in the treatment of fractures of lower limb combined with vascular injuries, and to evaluate its reliance.

METHODSFrom March 2006 to March 2008, 28 patients with fractures of lower limb combined with vascular injuries were graded by MESS scoring system. There were 17 patients were male and 11 patients were female, ranging in age from 23 to 53 years, averaged 38 years. Seventeen patients had fractures at the superior segment of tibia and fibia, 7 patients had fractures at the inferior segment of femur, and other 4 patients had dislocation of knee joint. Among the patients, 18 patients had MESS scores more than 7.0 point, in which 13 patients were treated with one-stage amputation, 5 patients were treated with two-stage amputation; the other 10 patients had the MESS scores less than 7.0 point, and were treated with open reduction and internal fixation, in which 8 patients were treated with transplantation of great saphenous vein to repair blood vessles, and 2 patients were treated with vascular end to end anastomosis.

RESULTSAmong the patients, including 18 patients whose MESS scores more than 7.0 point were treated with one-stage or two-stage amputation, and 10 patients whose MESS scores less than 7.0 point were treated with limb salvage operations, all the limbs survived. During the follow-up period (ranged from 0.5 to 1 year, the movement and sensory function of the limbs recovered well.

CONCLUSIONMESS is a simple and reliable tool to determine the proper strategy for the patients suffering from vascular injuries with fractures.

Adult ; Amputation ; Blood Vessels ; injuries ; Female ; Fracture Fixation ; methods ; Fractures, Bone ; surgery ; Humans ; Lower Extremity ; blood supply ; injuries ; Male ; Middle Aged ; Trauma Severity Indices ; Vascular Surgical Procedures