Vascular trauma

Vascular trauma arises from a variety of causes: penetrating and blast injury in conflict zones; blunt injury from road traffic accidents and falls; and iatrogenic injury from modern invasive medicine. Massive haemorrhage is the pre-eminent cause of preventable death and trauma teams now understand the necessity to control bleeding rapidly, so that effective resuscitation can begin. Vascular surgeons are key members of the trauma team, offering control of bleeding and vascular reconstruction, using aspects of open surgical and endovascular techniques. Unstable trauma patients with haemorrhagic shock require targeted damage-control surgery and goal-directed resuscitation, before the lethal triad of shock, hypothermia and coagulopathy make attempted salvage futile. Once stability has been established, definitive surgical care can restore function and allow successful rehabilitation.