Combat Vascular Trauma Management for the General Surgeon
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Purpose of Review
This review focuses on the initial management and stabilization of complex vascular injuries for the general surgeon within the combat zone.
Recent conflicts in Iraq, Afghanistan, and Syria demonstrate that general surgeons are responsible for the initial surgical management of combat-related vascular trauma in damage control scenarios. These injuries display a more complex injury pattern and often require different management strategies than seen in civilian trauma.
Vascular trauma in combat settings is often accompanied by a multitude of life- and limb-threatening injuries. Definitive repair operations are often deferred for initial damage control surgery and resuscitation. Resultant strategies to restore perfusion and control bleeding are determined by the patient’s underlying physiology and frequently require the use of vascular shunts, ligation, primary anastomosis, or interposition grafting. While general surgeons in the combat zone are not typically responsible for definitive repair during initial damage control surgery, proper initial surgical management in the far-forward setting with an intimate understanding of future repair strategies remains critical aspects in assuring optimal definitive treatment.
KeywordsVascular trauma Vascular injury Combat trauma Penetrating vascular injury Vascular injury stabilization Arterial injury
Compliance with Ethical Standards
Conflict of Interest
The authors have no conflict of interests to declare.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
The authors have no relevant financial interests to disclose.
The views expressed are those of the authors and do not reflect the official policy of the Department of the Army, the Department of Defense, or the U.S. Government.
The views expressed herein are those of the authors and are not to be construed as official or reflecting the views or policies of the Madigan Army Medical Center, the Scripps Mercy Medical Center, or the Department of Defense.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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