Biomedical subjects
Publications and source records attributed to I Tonković.
The authors reviewed the problems of vascular injuries with fractures in the nearness of joints. They have pointed out the period from injuries to the operations. Particularly they accentuated importance of team work between bone and vascular surgeons. The paper emphasied the evaluation of the possibility and develop to the good and complete functional restitution of the extremity.
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The purpose of this study was to compare the recent results of the abdominal aortic aneurysm (AAA) surgery, with the results for the patients operated ten years ago, and to identify the factors influencing the operative results. Two groups of patients were selected using a retrospective case series study. First group of patients (A) consisted of 32 cases operated in the period between 1984 and 1986, and the second group (B) consisted of those operated ten years later (from 1994 to 1996). Mortality rate, presence of risk factors, demographic data, and operative factors were analyzed and compared between the groups. The mortality rate decreased from 10.7% in period A, to 5.3% in period B for elective operations, and from 75% to 44.4% for emergency operations. The prevalence of straight graft technique in period B showed statistically significant difference compared to period A (p < 0.005). Besides, the operating time and the amount of the transfused blood between the groups differed significantly (p < 0.05). On the basis of this data, we concluded that the modifications in the operative technique, as well as the increased number of operations within the second period led to the decreased mortality rate in patients operated for AAA.
In this article the authors review their personal experience with shotgun injuries to the blood vessels. To date literature demonstrates a significant difference between the military injuries to the blood vessels versus the peacetime ones in the terms of healing. Injuries from high velocity missiles as well as blast injuries produce a massive damage of the tissue, muscles, bones, nerves and blood vessels. Therefore, such injuries demand a careful and appropriate primary surgical treatment and urgent revascularization within the ischemic tolerance of the tissue.
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Between April 1991 and December 1995, 118 patients were treated for wartime venous injuries. There were 108 (91.5%) venous injuries combined with arterial ones, and 52 (49%) with bone fractures. A total of 85 (72%) venous repairs were done and 33 (27.9%) were treated by ligation. Arteriovenous fistulas were found in 20 (16.9%) venous injuries. Venous injuries were associated with 10 (62.5%) amputations and 5 (45.4%) deaths. In the early postoperative period the authors found 15 (17.6%) thromboses of venous reconstructions.
The experience with military vascular injuries in the recent war in Crotia is reviewed. From April 1991 to October 1995, 197 wounded persons with 231 injuries of arteries were admitted to the University Hospital Rebro. The most common injuries were of lower extremity arteries (54.5%), and the most frequent method of repair was revascularisation with saphenous vein graft interposition. Fasciotomies were performed in 34% because of frequent associated injuries of bones (34.5%) and veins (46.7%). In 20.7% casualties pseudoaneurysms and arteriovenous fistulas were found. Postoperative thrombosis (9%) was a consequence of local infection, massive necrosis and sepsis. Amputation rate was 7.7%, and mortality 5.3%. These results are very satisfactory in comparison with the results in literature. This is a result of good organization of our war surgical service: rapid transportation of wounded persons to convenient surgical centres and high surgical skill.