- CODEN : IAJPBB
- issn 2349-7750
TITLE:
CAN GENERAL SURGEONS SUBSTITUTE VASCULAR SURGEONS IN EMERGENCY!!
AUTHORS:
Momna Tahir, Saadia Sardar, Tehreem Hannan
ABSTRACT:
The increasing cases of road traffic accidents and firearm injuries have increased the incidence of vascular injuries. There is huge burden of vascular surgical diseases and general surgeons are helping vascular surgeons to reduce surgical workload. Objective: To determine the various factors leading to poor outcome of vascular repairs done by general surgeons Study Design: Retrospective study Setting: General Surgery Emergency Department, Allied Hospital, Faisalabad. Duration Of Study: From Jan, 2014 to May, 2019 Methodology: All patients of all age groups who required emergency vascular surgery, diagnosed by consultant surgeon at surgical emergency were included. Operations were performed after pre-anesthetic evaluation by consultant general surgeons. Variables including injury type, vessel injuries, injury severity score (ISS), surgical repair done, hospital stay, complications and mortality, were recorded from old data. Various complications after the surgery were compared with the type of repair done, age group and time till presentation after injury. The p-value <0.05 was considered significant. Limb amputation or mortality was taken as poor outcome. Results: Retrospective data showed 135 patients with mean age 28.8 + 11.5 years (14 -63) most of which were males (127 of 135). Limb salvage rate and mortality was 74.8% and 4.4%, respectively. Complications occurred in 38/135 (28.1%) cases with wound infection (18%) and myonecrosis (6.7%) on top. No complications were seen in 71.9% cases. Factors leading to poor outcome/complications were GCS <12 (p=0.01), referred case (p=0.04), significant bleeding (p=0.004), Hb <9 at presentation (p=0.001), bone fracture (p=0.01), involvement of lower limb and late presentation (p=0.003). Conclusion: Late presentation in hospital is the major modifiable factor improvement of which can lead to better outcome, apart from the early and proper surgical intervention. In shortage of vascular surgeons, general surgeons can substitute vascular surgeons. Keywords: Vascular surgery, artery repair, venous graft, vascular anastomosis,
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