Investigation and Comparison of Therapeutic Outcomes Due to Penetrating Vascular Trauma of the Upper and Lower Limbs in Patients Referred to Ahvaz Golestan Hospital

Ghaedamini, Hossein; Mousavi, Seyed Masood; Zargar, Mohammadamin; Nazari, Iraj; Fadaei, Zohreh; Ghaedamini, Amirmahdi

doi:10.30491/tm.2025.494543.1793

Investigation and Comparison of Therapeutic Outcomes Due to Penetrating Vascular Trauma of the Upper and Lower Limbs in Patients Referred to Ahvaz Golestan Hospital

Document Type : Original Article

Authors

Hossein Ghaedamini ¹

Seyed Masood Mousavi ¹

Mohammadamin Zargar ¹

Iraj Nazari ¹

Zohreh Fadaei ²

Amirmahdi Ghaedamini ³

¹ Department of General Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, I.R.Iran.

² Department of Anesthesiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, I.R.Iran.

³ Student Research Committee, School of Medicine, Tehran University of Medical Sciences, Tehran, I.R.Iran.

10.30491/tm.2025.494543.1793

Abstract

Introduction: Limited research has been done on vascular traumas of the upper limb and their comparison with those of the lower limb. This research was conducted to determine and compare the therapeutic outcomes of penetrating vascular trauma of the upper and lower limbs in patients referred to Golestan Ahvaz Hospital in 2024.
Methods: This was a descriptive-analytical and prospective study. The sample size was determined using the census (820 participants). Information was obtained through the medical records and entered into the checklist. Primary outcomes included mortality, rehospitalization, amputation, and revascularization interventions, and other outcomes included operative complications and neurological deficits, which were compared in two groups of upper and lower limb injuries.
Results: The frequency of arterial involvement (P=0.003), compartment syndrome (P=0.014), and nerve injury (P=0.005) was higher in the upper limb group. The duration of hospitalization in the lower limb group was significantly longer (P=0.003). In treating penetrating arterial injuries, the rate of primary anastomosis (P=0.006) and ligation of arterioles (P=0.039) was significantly higher in the upper limb group. In comparison, the rate of using venous interposition graft (P=0.032) was significantly higher in the lower limb group. In treating venous injuries, the rate of fasciotomy (P=0.031) was significantly higher in the lower limb group. Mortality rate (P=0.023), amputation (P=0.001), need for reoperation (P=0.041), and need for therapeutic fasciotomy (P=0.001) in the lower limb group were significantly higher. At the same time, the frequency of nerve damage (P=0.003) was significantly higher in the upper limb group.
Conclusions: The results show a difference between the initial manifestations, management, and surgery and the outcomes of penetrating injury of the upper and lower limbs, which suggests that attention to penetrating injury seems necessary to prevent mortality and morbidity.

Keywords

Extremity

Iran

Artery

Vein

Trauma

Subjects