LARGE BLOOD vessels lie in sheltered positions in the body and are infrequently injured in civilian life. Most surgeons see relatively few fresh injuries of large blood vessels in their lifetime; however, any surgeon who is particularly interested in vascular problems will encounter an appalling number of disabling complications, amputations, and even deaths resulting from inadequate and improper treatment of vascular injuries.1 Most of these catastrophes could be avoided if a few principles of management were better understood and more widely practiced. It is therefore appropriate to review, clarify, and augment these principles from time to time.
A blood vessel may be compressed, contused, partially severed, or completely severed. Compression usually results from angulation of a fractured bone, hemorrhage or swelling within an unyielding fascial compartment, or injudicious use of a tourniquet. It is easy to detect if one is aware of the danger and remembers to palpate the