ANALYSIS OF IMMEDIATE AND LONG-TERM RESULTS OF TREATMENT OF VASCULAR LIMB INJURY

The experience of treatment of 35 patients with acute vascular trauma of limbs aged 20-50 years (29 of them are men (83%)) who were treated at the clinic of military field surgery of the S.M. Kirov Military Medical Academy was analyzed during the period from 01.01.2001 to 01.07.2011. Assessment of the immediate results of surgical treatment was performed using the original database that accumulates information on the treatment of patients with injuries of the main vessels of the limbs. The criterion for the development of surgical treatment tactics was the modified VPH-MESS scale, which makes it possible to predict with high reliability the need for amputation or the ability to save the limb. It was shown that half of the victims were delivered to the clinic with a shock of the I-II degree (46%), 43% were in a terminal state, every tenth victim was admitted to the clinic without signs of shock. The average VPH-MESS score was 6.77 ± 1.80. During surgical treatment (73% emergency operation), halting of profuse external bleeding in half of the cases was done without applying a vascular suture, in a quarter with a vascular suture, auto-venous prosthetics were performed to two victims. 59% of patients in the postoperative period had complications. It was shown that 62% of the victims retained their bearing ability, the sensitivity and movements of the injured limb were restored, the range of movements was reduced in 15%, 20% had a markedly reduced sensitivity and limited amplitude of movement. Additionally, long-term results of their treatment (from 1 year to 7 years) were analyzed in 12 patients using the questionnaire for assessing the quality of life of SF-36. The quality of life of victims with damage to the vessels of the extremities in the long term after treatment corresponds to the quality of life of healthy people: the level of generalized physical health component (RSH) was 51.01 ± 5.4, generalized psychological component of health (MSN) was 57.89 ± 3.9. The indicator of the psychological component of health significantly exceeds the parameter of the physical component of health (p<0.05).

vessels, trauma, limbs, treatment, immediate results, long-term results, quality of life