In North India, with a low risk of personal violence, blunt injuries, mostly motor vehicle accidents, account for 84 % of vascular injuries. The amputation rate was only 8 % after vascular repair. In the current warfare conditions of the American intervention in Iraq and Afghanistan,Fox and his group reported that vascular trauma represents 7 % of total battle injuries, 88 % of these were extremity injuries. It may be that life-threatening vascular injuries were pre-selected by their failure to survive transport. In an unparalleled large study from Vietnam, Rich and colleagues reported a total death of only 1.7 % for all vascular injuries. Thoracic vascular injuries routinely have death rates between 30–50 % vascular injuries to extremities are significantly lower in the range of 5 %, in a civilian reality. Deaths from vascular injury diverge considerably with anatomic location and mechanism of injury. In Australia vascular injuries represent 1–2 % of total trauma patients, however it account for 20 % of all trauma related death. There is wide variation in the incidence, cause and mechanism of injury depending on geographic conditions. The literature is filled of epidemiological researches demonstrating the features of vascular trauma in a variety of countries. Also, this will focus on the treatment of injured arteries, although attention will be given to those venous injuries, which require surgical repair rather than simple ligation. It is the purpose of this position paper to discuss neck, chest and extremities trauma, bringing to light recent evidence based data as well as expert opinions. Therefore, the particular specialized surgical skills, techniques and materials for the care of these patients need to be at the disposal of the trauma surgeon. These are acute events demanding immediate intervention to save life and limb and precluding any attempt at transfer or referral. As a result, trauma to major vessels is a not uncommon clinical occurrence. Trauma, both blunt and penetrating, is extremely common worldwide.
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