Vascular trauma and reconstructive approaches.

Vascular trauma is becoming more common in children. Iatrogenic injuries are beginning to yield to accidental and intentional trauma as the leading cause. In addition to technical considerations, difficulties in the management of these injuries include the high incidence of spasm and the effects of diminished blood flow on limb growth. The literature regarding pediatric vascular injuries is reviewed. Evaluation and management of these injuries is then discussed, with emphasis on the special problems encountered in children as well as on some areas of controversy. Prevention is still the best treatment for iatrogenic as well as traumatic vascular injuries in children.