Research Paper Title

Diagnosis and treatment of traumatic vascular injury of limbs in military and emergency medicine: A systematic review.

Background

Traumatic vascular injury is caused by explosions and projectiles (bullets and shrapnel); it may affect the arteries and veins of the limbs, and is common in wartime, triggering bleeding, and ischaemia.

The increasing use of high-energy weapons in modern warfare is associated with severe vascular injuries.

Methods

To summarise the current evidence of diagnosis and treatment for traumatic vascular injury of limbs, for saving limbs and lives, and put forward some new insights, the researchers comprehensively consulted the literature and analysed progress in injury diagnosis and wound treatment, summarised the advanced treatments now available, especially in wartime, and explored the principal factors in play in an effort to optimise clinical outcomes.

Results

Extremity vascular trauma poses several difficult dilemmas in diagnosis and treatment.

The increasing use of high-energy weapons in modern warfare is associated with severe vascular injuries. Any delay in treatment may lead to loss of limbs or death.

The development of diagnose and treat vascular injury of extremities are the clinical significance to the tip of military medicine, such as the use of fast, cheap, low invasive diagnostic methods, repairing severe vascular injury as soon as possible, using related technologies actively (fasciotomy, etc).

Conclusions

The researchers point out the frontier of the diagnosis and treatment of traumatic vascular injury, also with a new model of wartime injury treatment in American (forward surgical teams and combat support hospitals), French military surgeons regarding management of war-related vascular wounds and Chinese military (“3 districts and 7 grades” model).

Many issues remain to be resolved by further experience and investigation.

Reference

Xu, Y., Xu, W., Wang, A., Meng, H., Wang, Y., Liu, S., Li, R., Lu, S. & Peng, J. (2019) Diagnosis and treatment of traumatic vascular injury of limbs in military and emergency medicine: A systematic review. Medicine (Baltimore). 98(18), pp.e15406. doi: 10.1097/MD.0000000000015406.