Fatal traumatic vascular lesions in the neck, thorax and abdomen: a five-year study

Abstract

In the specialties of General Surgery and Angiology and Vascular Surgery, traumatic vascular injuries remain a major challenge. The main objective of this research was to characterize fatal traumatic vascular lesions in the neck, thorax and abdomen at the Arnaldo Milian Castro Provincial University Hospital during a 5 years period (2007-2011). An observational descriptive cross-sectional study was conducted. Of the universe (236 patients), a non-random sample of 213 patients was selected. The main results were: most patients (158) died on the scene and only 24% arrived alive at hospital. There were 434 injuries. The most common causative agents were traffic accidents (56.7%) and sharp weapons (31.6%). The chest was the most affected region with 45.6%. The predominant type of injury was the whole section of the spleen with 55.5%. Surgical treatment could only be applied in 10.3% of cases, with laparotomy and lateral suture being the most frequent surgical procedures (63.6%). Concerning damage control surgery performed in stage I, the hepatic packing (6 patients) was the most widely used procedure and 3 of the patients survived stage II and reached stage III, the hepatic packing was removed and the final repair was conducted. Of the deadly triad, acidosis was present in 100% of patients. The most common postoperative complications were surgical site infection with 54.5% and intra-abdominal abscesses with 36.4%. The hypovolemic shock was the predominant direct cause of death with 56.7%. Finally, it was determined that 36.5 years were not lived as a result of vascular lesions.