Single-Center Experience in Treating Peripheral Vascular Injuries in Vietnamese Children.

Abstract

Objectives: We report our hospital-based experience in management strategies and outcomes for pediatric extremity vascular trauma at a major trauma center. Methods: A retrospective chart review was conducted on patients under 18 with extremity vascular injuries who had surgery between May 2021 and February 2023. Results: Among 46 children, 16 (34.8%) had upper extremity injuries, while 30 (65.2%) had lower extremity injuries. Blunt trauma mechanism (82.6%) was dominant, followed by penetrating (17.4%). In all, 34 patients (73.9%) had at least 1 extremity injury, including 14 open fractures. 58.9% of patients did not present with acute ischemic syndrome. Regarding vascular repair, 16 patients (34.8%) underwent direct revascularization, 13 (28.3%) cases involved arterial dilatation using a Fogarty catheter, 9 patients (19.5%) had vascular repair using the great saphenous vein, and 1 case had cephalic and basilic venous repair using an allograft vein. Six patients had a temporary external fixation for complex lower limb fractures. One patient had a secondary amputation after a popliteal injury. One death was documented (2.7%). Conclusions: Blunt trauma poses challenges in pediatric cases. Vascular surgeons must consider children's future growth. Early diagnosis and treatment by experienced vascular surgeons at major surgical centers can lower mortality and amputation rates.