It was established during the Second World War that the operation to be preferred in field conditions is that of ligating vessels in the wound; vascular sutures were used in 0.8% of cases only.
Ligating large vessels may lead to necrosis of the extremity and, as a rule, always results in its reduced function because of inadequate blood supply. This had been stated long ago by A. P. Krynov:
"In a number of cases I had the occasion of ligating large arteries, such as the subclavian, iliac, femoral arteries, etc., and I should like to note that even if no necrosis of the extremity was observed after ligation, such patients subsequently exhibited all kinds of trophic disturbances on these extremities."
From the papers published during the Second World War, I have collected the following data regarding the occurrence of gangrene after ligation of the femoral and popliteal arteries: The ligation
ANDROSOV PI. New Method of Surgical Treatment of Blood Vessel Lesions. AMA Arch Surg. 1956;73(6):902–910. doi:https://doi.org/10.1001/archsurg.1956.01280060002002
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