Ateşli Silah Yaralanmalarında Üst Ekstremite Arteriyel Yaralanmalarının Değerlendirilmesi

Objective: In this study, we aimed to analyze concomitant injuries, Mangled Extremity Severity Score, morbidity, mortality and surgical methods in patient who admitted to our hospital, diagnosed with upper extremity arterial injuries caused by gunshot wounds due to the ongoing civil war in Syria. Material and Methods: Forty two patients that were diagnosed with upper extremity arterial injuries caused by gunshot wounds, and had surgery in our clinic between April 2012 and November 2014 were included in this study. Results: There were 40 (95.23%) males and 2 females (4.77%) with a mean age of 28.28 (17-67) years. Among those 42 cases, 19 (45,23%) had brachial artery injuries, 7 (16.66%) had subclavian artery injuries, 5 (11.90%) had axillary artery injuries, 5 (11.90%) had ulnar artery injuries, 4 (9.52%) had radial artery injuries, and 2 (4.76%) had both ulnar and radial artery injuries. The choice of arterial repair methods for 44 arterial injuries was saphenous vein graft interposition in 17 (38.63%), end-to-end anastomosis in 13 (29.54%), primary repair in 11 (25%), ligation in 2 (4.54%) and a polytetrafluoroethylene graft interposition in 1 (2.27%) injury. Amputation was performed in 2 (4.76%) cases. Mortality rate was 2.38%, that was seen in one case. Conclusion: In gunshot wounds, early diagnosis and rapid intervention are the crucial factors. We concluded that the initial medical intervention, arrival time to hospital, and region of injury affected mortality significantly. The corrosive effects of gunshot wounds must be considered while choosing surgical treatment.