PERÝFERÝK DAMAR YARALANMALARI

1994-2000 yýllarý arasýnda Turgut Özal Týp Merkezi Göðüs Kalp ve Damar Cerrahisi Kliniðinde 60 damar yaralanmasý vakasý görülmüþtür. Olgularýn 48'i erkek (%80), 12'si kadýn (%20) olup yaþlarý 5-70 (ortalama 28.9) arasýndaydý. Olgularýn yaralanma nedenleri; 34'ü (56.6) kesici-delici alet, 14'ü (%23.3) ateþli silah, beþi (%8.3) iatrojenik ve yedisinin (%11.6) künt travma sonucu olduðu belirlenmiþtir. Olgularýn 45'inde (%75) tam kesi, 14'ünde (%23.3) parsiyel kesi, birinde (%1.6) psödoanevrizma mevcuttu. Yaralanmalar 34 hastada (%56.6) üst ekstremitede, 26 hastada (%43.4) alt ekstremitede idi. Damar yaralanmalarýnýn lokalizasyonu sýklýk sýrasýna göre; femoral arter 12 olgu (%20), radial arter 10 olgu (%16.6), popliteal arter 10 olgu (%16.6), brakial arter dokuz olgu (%15), aksiller arter dokuz olgu (% 15), ulnar arter altý olgu (%10), tibialis posterior arter üç olgu (965) ve tibialis anterior arter bir olgu (%1.6) þeklinde idi. Olgularýn dokuzunda (%15) yandaþ ven yaralanmasý, 10 olguda (9616.6) ise sinir yaralanmasý vardý. Hastalarýn hastaneye ortalama varýþ süreleri 3 saat 30 dakika idi. Ortalama 95 dakika sonra revaskülarizasyon için operasyona alýndýlar. Cerrahi metod olarak vakalarda; 27 (%45) otojen safen ven interpozisyonu, 19 (%31.6) rezeksiyon + uç uca anastomoz, 10 (%16.6) lateral tamir, üç (% 3.2) sentetik greft ve bir (%1.6) ligasyon uygulandý. Serimizde ekstremite kurtarýlma oranýmýz % 98.2 dýr. Hastalarýn hastanede ortalama kalýþ süreleri 14.4 gündü. Hastalarýmýzýn hastanede kalýþ süresi içerisinde mortalite görülmedi.

PERIPHERIC VASCULAR INJURIES

Between 1994-2000, 60 peripheral vascular injuries were admitted to the Turgut Özal Medical Center Thoracic and Cardiovascular Surgery Clinic. Fourty eight (80 %) of patients were male, twelve (20 %) were female and their age ranged from 5 to 70 years (mean 28.9 years). The causes of injuries were related to penetrating device in 34 (56.6%), gun shots in 14 (23.3 %), blunt trauma in seven (11.6%) and iatrogenic causes in five(8.3 96). Total laceration, partial laceration and pseudoaneurysm were observed in 45 (75%), 14(23.3%) and one(1.6%) respectively. The localization of injuries were the upper limbs in 34(56.6%) and the lower limbs in 26 (414 %). The vascular injury localizations in order of frequency were femoral artery in 12 cases (20.75 %), radial artery in ten cases (17 %), popliteal artery in ten cases (15%), brachial artery in nine cases (15%), axillary artery in nine cases (13.2 %), ulnar artery in six cases (11.3%) and tibial artery in four cases( 7.4 %). There were nearby venous injuries in nine patients (15 %) and neural injuries in ten patients(16.6%). The patients' mean admission time to the hospital was 3 hours and 30 minutes and mean operation time for revascularization was within 95 minutes. The operative techniques were otogenous saphenous vein graft interposition in 27 cases (45 %), resection and end-to-end anastomosis in 19 cases (31.6%), lateral repair in ten cases (16.6%), synthetic graft insertion in three cases (4.8%) and ligation in one case(1.6%). Our success rate was 98.2 % in salvaging the limbs. Mean lenght of hospital stay was 14.4 days. Mortality was not observed during the hospital stay.