Deep vein thrombosis after gunshot injury.

Abstract

Pathophysiology and incidence for VTE: Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism (VTE), represent significant complication in trauma patients, particularly in combat settings where injuries often involve high-energy mechanisms such as blasts and ballistic trauma. Combat casualties face additional risks less prevalent in civilian settings, including early transfusion of blood products, the use of fresh frozen plasma outside of large volume blood transfusions, the use of tourniquets and multiple or above-knee amputations, contributing to the higher VTE incidence in military subgroups. The incidence of VTE in civilian patients who sustain firearm injuries is not available in the literature. Risk factors and scores for VTE: Trauma Embolic Scoring System (TESS) stands out as the most validated and effective clinical tool that assesses the risk of VTE for combat casualties due to its sensitivity in military trauma settings, addressing factors like shock and major leg injuries. Thromboprophylaxis strategies and guidelines: Guidelines for preventing VTE in patients suffering combat gunshot wounds emphasizes early prophylaxis, typically within 24 h of injury, using both mechanical and chemical methods.