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• W2077925141 abstract "We thank Drs. Subasi and Cakir for the comments. In response to their query regarding the priority of repair: vascular or orthopaedic; we believe that it is not the order of repair so much as the restoration of flow to the critically ischaemic limb that should take priority. The issue of which tissue should be repaired first has been a matter of debate for a long time, but there is no consensus on this issue, as can be seen in two reviews published recently. 1 Asfar S. Al-Ali J. Safar H. et al. 155 vascular injuries: a retrospective study in Kuwait 1992–2000. Eur J Surg. 2002; 168: 626-630 Crossref PubMed Scopus (12) Google Scholar , 5 Wolf Y.G. Rivkind A. Vascular trauma in high velocity gun-shot wounds and shrapnel-blast injuries in Israel. Clin North Am. 2002; 82: 237-244 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar The risk of damage to the arterial anastomosis during orthopaedic manipulation is present even when due care is exerted, especially so in areas where there is a risk of foreshortening, like the popliteal fossa or cubital fossa. Damage not recognised at the end of the operation can manifest later as pseudoaneuryms at best and anastomotic disruptions or thrombosis at worst. There are workers who argue that this risk is negligible. We believe it is best to leave the arterial repair for later as long as we are sure of the perfusion either through good collaterals or through a shunt. Temporary shunts restore perfusion more quickly than arterial repair itself and help reduce the warm ischaemia time in critically ischaemic limbs. Their liberal use has been supported in recent literature as well. 2 Bowley D.M.G. Degiannis E. Goosen J. Boffard K.D. Penetrating vascular trauma in Johannesburg, South Africa. Surg Clin North Am. 2002; 82: 221-235 Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar Extremity vascular trauma in civilian population: A 7-year review from North IndiaInjuryVol. 37Issue 3PreviewI read with interest the article in the March 2005 issue entitled “Extremity vascular trauma in civilian population: a 7-year review from North India” by Menakuru et al.3 The issue was evaluated very well, however, I think that there is still need for additional knowledge about the diagnosis of the vascular injury and which one is the priority for repair: vascular or orthopaedic. Full-Text PDF" @default.
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• W2077925141 date "2006-03-01" @default.
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• W2077925141 title "Extremity vascular trauma in civilian population: a seven year review from North India [Injury 2005 (36) 400–6]" @default.
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