OUTCOME AFTER PERIPHERAL VASCULAR INJURIE S IN MULTIPLE TRAUMA PATIENTS

The therapeutic concept of limb salvage or immediate amputation is con troversial in patients with multiple trauma. Sixty-three multiple trau ma patients (injury severity score ISS >18 patients) with blunt arteri al injuries were investigated. Twenty-seven had injuries of the tipper limb and 36 patients of the lower limb. In 33 cases a limb salvage pr ocedure was performed (group I), while in 30 cases the limb was amputa ted (group II). Neither group showed a significant difference in age ( I: 33+/-3, II: 30+/-3 years), ISS (I: 30+/-2, II: 29+/-2 patients), ti me of ischemia (I: 238+/-30, II: 203+/-20 min) ICU stay (I: 18+/-4, II : 19+/-4 days). Lethality and morbidity were slightly increased in gro up I (death: I: n=8; II: n=4; MOF: I: n=5; II: n=3; Sepsis: I: n=11, I I: n=4). No differences were found in the incidence of local infection s (I: n=12, II: n=10). Secondary amputations were performed in 7 patie nts after 12+/-2 days (range 3-40; median: 5 days). We conclude that l imb salvage did not increase the risk for severe complications. Lethal ity and morbidity were related to the severity of the injury. To preve nt complications, secondary amputations had to be performed early.