This paper describes some of the problems encountered in the repair of 18 civilian arterial injuries of the extremities (Table 1) and reemphasizes the value of the cardinal principles of arterial repair.
Prompt exploration and repair of all suspected arterial injuries are essential to prevent many of the complications. For example, emboli may arise from clots plugging tangential lacerations which do not occlude (Fig. 1). Urgent operation is also necessary to prevent irreversible ischemic changes and forestall distal thrombosis. Table 2 summarizes the 10 cases of emergency repair. Eight other cases came to us with sequelae of unrecognized or unrepaired arterial injuries, such as false aneurysms or arteriovenous fistulae, and these complications could have been avoided by prompt repair. Proximal and distal control of damaged vessels was achieved by long incisions placed for maximal exposure. Arterial continuity was always restored by anastomosis or grafting. Special training in arterial surgery for
HERSHEY FB, SPENCER AD. Surgical Repair of Civilian Arterial Injuries. AMA Arch Surg. 1960;80(6):953–962. doi:10.1001/archsurg.1960.01290230071009