Lukram Sidartha, Mohit Sharma, S. Dixit
Aug 25, 2014
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Quality indicators
Journal
Journal of Evolution of medical and Dental Sciences
Abstract
OBJECTIVE: The therapeutic role of Xanthinol nicotinate along with Heparin and Dextran-40 was studied in the management of 150 patients in whom distal pulsations were not felt immediately post arterial repair surgery. METHODS: This is a prospective study of 150 patients who underwent arterial repair surgery in the Department of Cardiothoracic & Vascular Surgery, Sawai Man Singh Medical College, Jaipur, Rajasthan. Such of those patients whose distal pulsations were not palpable immediately after the arterial repair surgery were chosen in this study. RESULTS: Data is checked for completeness, consistency, and analysed using SPSS version 16.0. Descriptive statistics like mean, proportion etc. were used.Road traffic accident (61.3%) was the major cause of arterial trauma, post orthopaedic procedure contributing only 2% of the arterial injury. Upper limb injury with trauma to radial and ulnar arteries (30%) is the commonest. Most of the patients presented with warm limbs and intact motor sensory power (37.5%). Frank bleeding with complete arterial transection was seen in 66 patients (44%). 58 patients (38.7%) had reusable limb post the infusion therapy. 35 cases (23.3%) ultimately went to amputation due to development of gangrene subsequently. CONCLUSION: Preoperatively, the time interval from injury to diagnosis by the vascular surgeon is very crucial in restoring the integrity of the vessel. The golden period of intervention is up to 8 hours post injury. Associated orthopaedic traumas (bone fractures)delays the primary arterial repair surgery. Combined infusion therapy of Dextran-40, Unfractionated Heparin and Xanthinol nicotinate was found effective in postoperative cases of arterial surgery where distal artery pulsation was not palpable.