Approach to major XXXX .

@entity1 @entity548 @entity1661 @entity260 @entity281 @entity1410 @entity1317 @entity715 @entity551 @entity130
@entity1317 account for 25% to 30% of all @entity1317 seen in urban @entity130 centers where penetrating wounds are the most common cause of @entity130 . @entity1 have moderate @entity551 if contained @entity1410 are present and present in extremis with massive @entity1661 , if @entity548 into the peritoneal cavity is occurring. Injuries occur in five areas, each containing its own vessels and techniques of exposure and vascular repair. Included are the midline supramesocolic, midline inframesocolic, lateral perirenal, lateral pelvic, and portal areas. In these areas, arterial repair is essentially always attempted, whereas ligation of major veins, if necessary, is well tolerated in many instances. Survival depends on the number and magnitude of associated vascular and @entity130 . If an operation can be performed soon after injury, survival with most major abdominal arterial injuries ranges from 35% to 85%. When major @entity1317 are considered, the survival rate ranges from 50% to 95%. @entity260 include @entity715 of repairs, dehiscence of suture lines, and @entity281 . Second-look operations may be beneficial to evaluate tenuous repairs, whereas various techniques are helpful in avoiding suture line breakdowns as a result of @entity281 .
