Rutherford Vascular Surgery 7th Pdf Download
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In blunt extremity trauma, vascular injuries are the most common type of trauma, accounting for 25% of all trauma injuries and 35% of all vascular injuries [11]. The most common site of vascular trauma is the distal forearm, with isolated injuries to the brachial artery at the elbow level and injuries to the lower arm with a prevalence of 41% [11].
Rutherford et al. proposed a treatment algorithm for penetrating and blunt injuries to the major limb arteries [7]. An initial management plan should be based on the anatomical and clinical characteristics of arterial injury and the presence of specific clinical signs [7]. In penetrating trauma, a dissection of a major artery proximal to an axial or rotating hinge point should be managed as a compartment syndrome. In patients with an anteromedial hinge-point injury and a suture line compressing the inflow tibial artery, the level of injury should be determined with the use of preoperative angiographic confirmation. For the treatment of a groin injury, it is suggested that the femoral vessels, GSV, first transverse, and branches within the adductor canal should be searched carefully before any distal vascular exploration. One should also treat the cavernous, superficial, and profunda femoris veins as the proximal structures in the same manner and should perform angiography and vein mapping in a distal-to-proximal fashion rather than a good-old-fashioned exploration approach.
Morrison et al. reviewed the sonographic features of soft-tissue trauma [21]. Soft-tissue injuries can be characterised by the presence of hematomas at the site of the injury and lack of fluid at adjacent pectoral, axillary and inguinal regions. Hematomas are usually clean. However, acute hematomas may contain air or inguinal spermatozoa. The presence of "fluffy hemopneumatocele" (4 to 15 mm in diameter) is highly specific for Grade III blunt trauma and therefore may be considered a sign of a high-energy injury. d2c66b5586