Additionally, the time since injury, may not necessarily reflect the actual period of ischaemia especially in closed vessel injuries. This is not to decry that delay in revascularization should not be minimised. Conventional logic dictates that longer the period of ischaemia the find protocol higher
the chance of limb loss. However to condemn limbs as unsalvageable purely on the basis of ischaemia time alone needs to be reconsidered. Finally it must be stressed that limb salvage alone is not sufficient and long term functionality which is often dependent upon the extent and recovery from associated neuromuscular and skeletal injuries must be considered Epigenetics activator in the overall outcome assessment. Nevertheless in Asian societies Selleckchem Ion Channel Ligand Library like ours where physical integrity of limbs often takes
precedence over functionality these aspects tend to be overlooked. Conclusion In conclusion, delays in presentation of extremity vascular injuries should not dissuade one from adopting an aggressive approach to repair and limb salvage after pre-procedure fasciotomy to establish muscle viability and pre-empt reperfusion induced compartment hypertension. References 1. Austin OM, Redmond HP, Burke PE, et al.: Vascular trauma-A review. J Am Coll Surg 1995, 181:91–108.PubMed 2. Compton C, Rhee R: Peripheral vascular trauma. Perspect Vasc Surg Endovascr Ther 2005, 17:297–307.CrossRef 3. Sugrue M, Caldwell EM, D’Amours SK, Crozier JA, Deane SA: Vascular injury in Australia. Surg Clin North Am 2002, 82:211–219.PubMedCrossRef 4. Fox CJ, Gillespie DL, O’
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