Vascular trauma of an upper extremity. Management in the acute stage

Abstract

The vascular trauma is an emergency situation at which we may be confronted in the emergency unit. This may cause the patient’s death if not made a timely management. The limbs represent the main site of injury in civilian population. 30% affect the upper extremity. The main etiology is penetrating trauma, specifically gunshot. There is also an alarming increase of iatrogenic injuries. The emergency surgeon should have an appropriate theoretical and practical knowledge to allow a proper diagnosis, and management in the acute stage. The main objective is to keep the patient alive and then the rescue of the limb. The current indication in the presence of objective signs is the classic surgical exploration, and there are some patients who could be resolved by endovascular surgery, specifically hemodynamically stable patients with injuries of the proximal brachial and axillary artery. This article presents the basic considerations in the emergency management of patients with upper extremity vascular trauma.