Management of lower extremity vascular injuries in pediatric trauma patients: A single Level i trauma center experience

Jason D. Sciarretta, Francisco Igor B. Macedo, Eunice Lee Chung, Christian A. Otero, Louis R. Pizano, Nicholas Namias

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background: Traumatic vascular injuries of the lower extremity in the pediatric population are rare but can result in significant morbidity. We aimed at describing our experience with such complex injuries, with associated patterns of injury, diagnostic and therapeutic challenges, and outcomes. Methods: From January 2006 to December 2011, 2,844 pediatric trauma patients presented at the Ryder Trauma Center, an urban Level I trauma center in Miami, Florida. Among them, 18 patients (0.6%) were evaluated for lower extremity traumatic vascular injuries. Variables collected included age, sex, mechanism of injury, and clinical status at presentation. Surgical data included vessel injury, technical aspects of repair, associated complications, and outcomes. Results: Mean (SD) age was ± 14.7 (2.6) years (range, 6-17 years), with 17 males (94.4%). Of the 18 traumatic pediatric patients, 32 vascular injuries were identified. All arterial injuries underwent definitive operative repair. Primary repair was performed in two patients (11.1%), six (33.3%) required saphenous vein interposition grafting as initial procedure, and eight (44.4%) underwent polytetrafluoroethylene grafting. Ligation was performed in major venous injuries and deep profunda branches. The overall survival in this series was 94.4%. Conclusion: Peripheral vascular injuries of the lower extremity in the pediatric population can result in acceptable outcomes if managed early and aggressively. Surgical principles of vascular surgery are similar to those applied to an adult. We recommend that these injuries should be managed in a tertiary specialized center with a multidisciplinary team of trauma surgeons, and pediatricians, which can potentially decrease morbidity and mortality. Level of Evidence: Epidemiologic study, level III.

Original languageEnglish (US)
Pages (from-to)1386-1389
Number of pages4
JournalJournal of Trauma and Acute Care Surgery
Volume76
Issue number6
DOIs
StatePublished - Jun 2014

Keywords

  • noniatrogenic vascular injury
  • Pediatric trauma
  • pediatric vascular injury
  • peripheral vascular injury

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

Fingerprint Dive into the research topics of 'Management of lower extremity vascular injuries in pediatric trauma patients: A single Level i trauma center experience'. Together they form a unique fingerprint.

  • Cite this