October 1985

Peripheral Vascular Trauma From Close-Range Shotgun Injuries

Author Affiliations

From the Division of Vascular Surgery, Department of Surgery, University of Illinois College of Medicine at Chicago, and Cook County Hospital, Chicago.

Arch Surg. 1985;120(10):1126-1131. doi:10.1001/archsurg.1985.01390340024004

• This report summarizes an eight-year experience (1976 to 1983) with 49 close-range shotgun blasts with associated major vascular injuries seen in a large urban hospital. Injuries to the upper extremity (40%), lower extremity (56%), and neck (4%) were seen. A high frequency of associated deep venous injury (82%), nerve injury (37%), fracture (33%), massive soft-tissue loss (43%), and compartmental hypertension (39%) was observed. There were no deaths in this series, and the limb salvage rate was 96%. Neither patient with multiple carotid artery injuries suffered a neurologic deficit. We attribute our success in the management of these complex injuries to rapid fracture immobilization, early and aggressive use of fasciotomy, adequate débridement of devitalized tissue, repair of deep venous injuries, arterial repair with autogenous tissue, and extra-anatomic bypass grafting in selected cases. (Arch Surg 1985;120:1126-1131)