Ateşli Silah Yaralanması Sonrası Spiral Ven Grefti ile Femoral Ven Tamiri

Öz

Alt ekstremite kompleks vasküler yaralanması sonrası arteryel restorasyon yanında venöz tamir yapılması uzun yıllar tartışmalı bir konu olarak kalmıştır. Venöz dolaşımın sağlanmaması ekstremite ödemi ve kompartman sendromuna yol açarak arteriyel dolaşımı bozmakta ve ekstremite kaybı insidansını artırmaktadır. Biz bu olgu sunumunda ateşli silahla yaralanmaya sekonder meydana gelen alt ekstremite vasküler travmasında spiral safen ven grefti tekniği ile uygulanan venöz tamir olgusunu sunduk

Anahtar Kelimeler

• Ekstremite; yara ve yaralanma; yaralanmalar, silahla yaralanma; femoralven.

Femoral Vein Repair with Spiral Vein Graft After Gunshot Injury

Öz

Performing venous repair, along with arterial restoration, following complex vascular injury of lower limb has stayed as an issue of debate for years. Unrepaired venous inflow increases extremity loss incidence by causing oedema and compartment syndrome which compromises arterial inflow. In this report we present a case in which we performed a venous repair using spiral saphenous vein graft technique for complex vascular trauma due to gunshot injury.

Anahtar Kelimeler

• Extremities; wounds and injuries; wounds, gunshot; femoral vein.

Kaynakça

1. Pasch AR, Bishara RA, Lim LT, Meyer JP, Schuler JJ, Flanigan DP. Optimal limb salvage in penetrating civilian vascular trauma. J Vasc Surg 1986;3:189-95.
2. Martin LC, McKenney MG, Sosa JL, Ginzburg E, Puente I, Sle- eman D, et al. Management of lower extremity arterial trauma. J Trauma 1994;37:591-8.
3. Barros D’Sa AA, Harkin DW, Blair PH, Hood JM, McIlrath E. The belfast approach to managing complex lower limb vascular injuri- es. Eur J Vasc Endovasc Surg 2006;32:246-56.
4. Küçükarslan N, Öz BS, Özal E, Yıldırım V, Tatar H. Ateşli silahla oluşan vasküler yaralanmaların cerrahisinde morbidite ve morta- liteyi etkileyen faktörler: Gözden kaçan arteryel yaralanma, ihmal edilmiş ven tamiri. Ulusal Travma Acil Cerrahi Derg 2007;13:43-8.
5. Makins GH (ed). On Gunshot Injuries to the Blood Vessels. Bristol, England: John Wright and Son, 1919:21-3.
6. Debakey ME, Simeone FA. Battle injuries of arteries in World War II: analysis of 2471 cases. Ann Surg 1946;123:534-79.
7. Barcia PJ, Nelson TG, Whelan TJ. Importance of venous occlusion in arterial repair failure: an experimental study. Ann Surg 1972;175:223-7.
8. Yelon JA, Scalea TM. Venous injuries of the lower extremities and pelvis: repair versus ligation. J Trauma 1992;33:532-6.

9. Hardin WD Jr, Adinolfi MF, O’Connell RC, Kerstein MD. Manage- ment of traumatic peripheral vein injuries. Primary repair or vein ligation. Am J Surg 1982;144:235-8.
10. Zamir G, Berlatzky Y, Rivkind A, Anner H, Wolf YG. Results of re- construction in major pelvic and extremity venous injuries. J Vasc Surg 1998;28:901-8.
11. Pappas PJ, Haser PB, Teehan EP, Noel AA, Silva MB Jr, Jamil Z, et al. Outcome of complex venous reconstructions in patients with trauma. J Vasc Surg 1997; 25:398-404.
12. Erbasan O, Arslanoğlu A, Pişkin B. Mayın patlamasına bağlı pop- liteal arter ve ven yaralanması: Olgu sunumu. Gülhane Tıp Derg 2008;50:220-2.
13. Thomson JG, Kim JH, Syed JH, Reid MA, Madsen J, Restifo RJ. The effect of prolonged clamping and vascular stasis on the pa- tency of arterial and venous microanastomoses. Ann Plast Surg 1998;40:436-41.