Penetrating Venous Extremity Trauma, Management of

Published 2002

Level 1

A. Level 1
There is no class I evidence to support a standard of care for this parameter.

Level 2

B. Level 2
There is no class 2 evidence to support a standard of care for this parameter.

Level 3

C. Level 3

  1. There is insufficient data to recommend treatment for isolated venous injuries. Isolated venous injuries accompanied with active hemorrhage require exploration and cessation of bleeding. 
  2. Venous injuries found during exploration for associated arterial injury should be repaired if the patient is hemodynamically stable and the repair itself will not significantly delay treatment of associated injuries or destabilize the patient's condition. 
  3. Lateral venorrhaphy that does not significantly narrow the lumen or paneled grafts appear to be the best options for repair. Interposition vein grafts consistently have poor results, and synthetic grafts are the least desirable option for repair. 
  4. There is insufficient data to recommend adjunctive measures to improve vein repair patency. 
  5. Venous ligation in conjunction with leg elevation, compression stockings, and liberal use of fasciotomies offers similar results to repair. 
  6. Fasciotomy should be considered when there is a combined arterial and venous injury.