Rasmussen et al., have used temporary vascular shunts in 30 extremities as a damage control adjunct in the Iraq war, especially for major proximal vascular injuries [21]. There were no shunt related complications, 86% were patent and only 7% needed early amputation [21]. This simple technique was useful to stabilize and then transport patients. Ultrasound technology has dramatically evolved during the last two decades. New portable hand held ultrasound machines with excellent images and doppler color

facility can be used in the battle field [22]. Duplex ultrasound has been successfully used to diagnose vascular injuries during the recent Iraq Conflict [17]. Angiography / Endovascular means was Ulixertinib not used in our series. Therefore, it is possible that occult vascular injuries have been possibly missed and those usually present later [23]. The value of endovascular approach for both diagnosis and treatment Selleck Adriamycin of vascular injury in civilian and war practice is well studied [7, 24, 25] Fox et al. reported their experience of managing 107 soldiers with vascular injuries during the Iraq/Afghanistan wars [7]. They found that endovascular interventions resulted in lower morbidity and mortality in multiply injured patients. Conclusions Major vascular injuries occurred in 10% of hospitalized war injured patients. The presence of vascular surgeons within a military surgical team is highly recommended. Basic principles and techniques

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