SUCCESS RATE OF LIMB-SALVAGE SURGERY AFTER ARTERIAL INJURY OF LOWER EXTREMITIES IN PRINCE OF SONGKLA UNIVERSITY.

Background: Lower extremities arterial injury lead to high morbidity. The number of patients with lower vascular injury is still high especially in southern of Thailand. We have fewer reports about these and limbsalvage surgery is not suitable for all patients. Objective: This study aims to clarify the success rate of limb salvage surgery in patients with lower extremities arterial injury, associated factors and outcomes. Materials and Methods: This retrospective study of lower extremities arterial injury patients that received treatment in Prince of Songkla University from 2013-2017. Patients were classified into limb salvageable group and amputation group. Demographics, comorbidities, injury, operative data and complications were collected. Comparisons of limb salvageable and associated factors were analyzed using the Pearson chi-square or Fisher's exact test. Logistic regression analysis was performed to evaluate factors that may be associated with amputation. Results: 93 patients, 59 (63%) patients were successful in limb salvage surgery. The common site of injury was popliteal artery (49%) and Superficial femoral artery (16%) respectively. We found significant associated factors to limb salvageable such as blunt mechanism (limb salvageable group, 50.8%; amputation group, 76.47% P = 0.01), multiple injuries (limb salvageable group, 15.25%; amputation group, 35.29% P = 0.04), complex fractures (limb salvageable group, 39.13%; amputation group, 15.63% P = 0.02) and smoking (limb salvageable group, 39.13%; amputation group, 15.3% P = 0.04). After multivariate analysis, blunt mechanism injury is only the predictive factor for amputation (OR, 5.2; 95% CI 1.40-19.06; P = 0.01). The common complications were surgical site infection (limb salvageable group, 20.34%; amputation group, 35.29% P = 0.142) and fail to perform skin closure of fasciotomy wound (limb salvageable group, 39.13%; amputation group, 15.63% P = 0.02). Conclusion: Most patients with lower extremities vascular injury were successful in limb salvage surgery. However, our study found a higher amputation rate compared with previous studies. Limb salvageable was associated with blunt mechanism, multiple injuries, smoking and complex fractures. [ABSTRACT FROM AUTHOR]