Femoral vessel injuries; high mortality and low morbidity injuries.

Femoral vessel injuries are amongst the most common vascular injuries admited in busy trauma centers. The evolution of violence and the increase in penetrating trauma from the urban battlefields of city streets has raised the incidence of femoral vessel injuries, which account for approximately 70% of all peripheral vascular injuries. Despite the relatively low mortality associated with these injuries, there is a high level of technical complexity required for the performance of these repairs.

Iliac vessel injuries: difficult injuries and difficult management problems.

Introduction: Injury to the iliac vessels poses a serious and frustrating treatment dilemma for all trauma surgeons. Generally, patients present in profound shock secondary to severe hemorrhage from either iliac arterial, venous, or combined injuries. Despite improvements in our emergency medical services (EMS), rapid transport, standard training of trauma surgeons, and improved technology, the morbidity and mortality from iliac vessel injuries remain high, ranging from 25 to 40 %.

Brachial vessel injuries: high morbidity and low mortality injuries.

Introduction: Reports of arterial injuries from both the civilian and military arenas report the brachial artery as the most frequently injured vessel, accounting for approximately 25-33% of all peripheral arterial injuries. The brachial artery is surrounded by important peripheral nerves -the median, ulnar and radial, and also parallels the humerus and associated veins. Due to its close proximity to these structures, associated nerve and osseous injuries are frequent with residual neuropathy from such nerve injuries, often the main sources of permanent disability.

Nosocomial urinary tract infection.

Nosocomial urinary tract infection, a common complication in surgical patients, is primarily related to the use of indwelling urinary catheters. Discontinuation of catheter usage within 2 days, whenever possible, is the cornerstone to avoiding these infections. Patients with asymptomatic bacteriuria may be treated with catheter removal only, and do not necessarily require antibiotic therapy.