# Damage control strategy in peripheral vascular injury caused by firearm: A case report

## TL;DR

A 28-year-old man with a severe leg injury from a gunshot was treated with a damage control strategy to preserve his limb and avoid amputation.

## Contribution

This case report highlights the successful use of a damage control strategy with vascular shunts and grafts in managing firearm-induced vascular injury.

## Key findings

- A vascular shunt was used to temporarily restore blood flow and prevent limb loss.
- The patient recovered well with palpable pulses and no need for further surgery.
- Damage control strategy effectively managed critical vascular injury in a firearm wound case.

## Abstract

In peripheral vascular injury, the need for amputation following prolonged ischemia can be avoided through rapid revascularization. However, critically ill patients often cannot undergo single-stage surgery; thus, the use of vascular shunts temporarily alleviates ischemia, protecting the limb until definitive treatment. The present study describes the case of a 28-year-old male patient with a vascular injury in the right leg secondary to a firearm wound. Following admission, he developed grade IV hypovolemic shock. The patient underwent surgery, where a complete transection of the popliteal artery was found, and a shunt was placed for ischemic control. During surgery, he developed metabolic acidosis and was transferred to the intensive care unit for stabilization. The patient was transfused and underwent a second procedure for an inverted saphenous vein graft. The patient exhibited good clinical progression with palpable distal pulses in the affected limb. The damage control strategy in the case described herein allowed for the preservation of the affected limb, with no complications or need for further surgical intervention observed.