الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Vascular injuries are becoming a major contributor of limb loss in third world countries due to violence, terrorism and unavailability of vascular facilities. This morbidity can be reduced by improving law and order situation, evolving an effective emergency ambulatory system and with better training and provision of vascular services in remote areas so that the delay factor can be reduced. Aim of the work: is to assess the incidence, overall management and outcomes of vascular injuries of lower limb in trauma patients. Patients: This was a prospective observational study that was conducted over 200 trauma patients with admitted to Mansoura University Emergency Hospital a level 1 trauma center within the period from January 2019 to January 2020 Methods: Primary survey and resuscitation (Airway, Breathing, Circulation, Disability and Exposure). Active bleeding should be controlled by direct pressure. Blind clamping of vessels can lead to nerve damage. A tourniquet can be applied if direct pressure is not sufficient using a tourniquet for up to six hours is considered safe in most instances. Hypotensive resuscitation (or permissive hypotension) should be considered in cases of arterial injury, in which a clot that is preventing hemorrhage could blow off from a higher pressure .target systolic blood pressure in hypotensive resuscitation is 90 mmHg. AMPLE History: Clinical examination of the patients at the trauma room including: Vital signs (Arterial blood pressure, Temperature, pulse, respiratory rate). Glasgow coma scale (GCS). Complete general examination: Lower limb examination: Hard signs and Soft signs: Results& Conclusion: The current study demonstrated that, vascular traumatic injuries of the lower limbs were common are becoming major contributors of limb loss. They usually developed in males due to penetrating injuries in which direct trauma and RTA representing the main etiologies. In addition, proper and immediate intervention may play an essential role in the reduction of the resulting consequences such as amputation and death. Recommendations: Immediate management of vascular lower limb injury plays an important role in limb preservation. All patients with extremities trauma should be evaluated for the presence of hard signs and soft signs of vascular injuries. Emergency physicians should have high index of suspicion of vascular injury and be able to refer promptly.