A ten year audit of surgery for vascular trauma in a British teaching hospital

Abstract

Vascular trauma is uncommon in the U.K. with the exception of Northern Ireland. In marked contrast to North America, gunshot mounds are rare and stabbings are infrequent. A 10 year audit was carried out in a regional vascular referral unit to determine the mechanisms, treatment and outcome of vascular injuries. Forty-seven patients were operated on during the period. The median age was 26 years (range 7-85 years); two-thirds were men. Road traffic accidents accounted for 21 (45%) of injuries, other accidents 15 (32%) and stabbings 12 (23%). There were no gunshot wounds. Most injuries were penetrating with no associated fracture. Commonly injured vessels were the brachial (30%) and superficial femoral (15%) arteries. Fifty-three primary operations were performed, 10 were vein interpositions and 21 were bypass grafts. There were three primary amputations (6%). Eleven patients suffered a complication including one death. One graft occluded requiring a further bypass. Two patients required fasciotomy as a secondary procedure. Median follow-up was 6 months. Eighty-one percent of patients were symptom free at last follow-up. There were no late vascular complications. Our experience is likely to represent that of other vascular units in countries with strict gun control legislation, little civil violence and modest levels of road traffic accidents.