SURGICAL TREATMENT OF VASCULAR INJURY WITH TRAUMATIC SHOCK

Abstract

Aim of study. Identify the features and offer the best tactics for the surgical treatment of vascular injuries in traumatic shock.

Material and methods. The clinic has 36 patients with hemorrhagic and traumatic shock. Of them: 33 men (91.6%), women 3 (8.3%). We found, among those admitted to the clinic, 36 patients with hemorrhagic and traumatic shock. So, in 5 patients, the condition was extremely serious. The use of angiography and MSCT is of great importance for the early diagnosis of traumatic vascular damage.

Results. We have performed 36 different operations for patients with shock after vascular injury: vessel ligature —  19; lateral suture —  5. Of them: at the same time imposed side seam venous vessels; сircular suture —  4; autovenous shunting —  3; prosthetics —  4: primary amputation —  1 and 7 patients with epineural suture. Along with this, severe shock, massive tissue damage and irreversible ischemia were indications for limb amputation in 1 (2,7%) patients with vascular damage. Arrosive bleeding was observed, only in one patient. In 24 (94,4%) patients, wound healing was primary, in 2 (5,5%) patients, wounds healed by secondary intention.

Conclusions. The high efficiency of timely application of reconstructive- restorative operations —  autovenous shunting and vascular prosthetics after stabilization of hemodynamic parameters depends on the degree of traumatic and hemorrhagic shock.