Vascular trauma

Abstract

Identification and management of vascular injuries is challenging. The surgeon must have a good understanding of the arteries and veins that are likely to be injured, and which diagnostic modalities are needed to identify the injury, as well as the surgical techniques necessary to repair these injuries. It is imperative that one knows how to diagnose a patient who is stable but who may have an unsuspected vascular injury as well as to manage the patient who is hemorrhaging from an obvious injury. Most patients with vascular injuries require a multidisciplinary approach to care, possibly including treatment from an interventional radiologist for diagnosis and endovascular management, an orthopedic surgeon for concurrent fracture management, cardiac surgeons or neurosurgeons for selected types of vascular injuries, and plastic surgeons for wound coverage.1 The trauma surgeon must remain in charge of the care of the trauma patient while simultaneously orchestrating all consultant services in a timely fashion to save both life and limb. This chapter presents an evidence-based approach to the evaluation and management of trauma patients with vascular injuries. © 2008 Springer New York.