A decade of missile-induced vascular trauma.

During 10 years of serious strife the Royal Victoria Hospital, Belfast, has dealt with trauma inflicted by a wide variety of missiles. Injuries involving 316 vessels were sustained by 192 patients. A group of "knee-cappings' accounted for a large proportion of popliteal vessel injuries. A majority of patients also suffered damage to other regions of the body. Hypotension was a notable feature and several patients arrived in extremis, particularly those with injuries to a major vessel trunks and vital organs. The benefits of rapid evacuation in relation to ischaemia time are discussed. The operative management of a wide range of arterial and venous injuries is described. The use of simple and compound vein grafts allowed adequate excision of damaged vessels. The advantages of meticulous repair, timely fasciotomy, and early reintervention are reflected in the results, contributing to the small lower-lib amputation rate of 5.1%.