IMPACT OF N-ACETYLCYSTEINE USE IN THE MANAGEMENT OF TRAUMATIC LOWER EXTREMITY VASCULAR INJURY - A PILOT RANDOMISED CONTROLLED TRIAL. dr_bagaria@yahoo.co.in

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IMPACT OF N-ACETYLCYSTEINE USE IN THE MANAGEMENT OF TRAUMATIC LOWER EXTREMITY VASCULAR INJURY - A PILOT RANDOMISED CONTROLLED TRIAL.

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Subodh Kumar subodh6@gmail.com AIIMS New Delhi Trauma Surgery & Critical Care New Delhi India

Amit Gupta amitguptaaiims@gmail.com AIIMS New Delhi Trauma Surgery & Critical Care New Delhi India

Sushma Sagar sagar.sushma@gmail.com AIIMS New Delhi Trauma Surgery & Critical Care New Delhi India

India

Oral or Poster

N-acetyl cysteine (NAC) known as a potent antioxidant and having cellular healing properties, showed improve amputation stump perfusion and healing in patients with persistent limb-threatening ischaemia. This randomised controlled trial was conducted to compare the rate of limb salvageability and other morbidities at 30 days post injury between 5 day NAC treatment and the placebo group

This study was a Pilot Prospective, Randomized controlled Trial. Patients who were scheduled for post trauma lower extremity vascular intervention were included in the study based on inclusion and exclusion criteria. The study subjects were randomized to two groups. Group A were treated with N-acetylcysteine 1200 mg iv bd in 100ml DNS over 30 – 60 mins for 5days and patients in Group B were given Dextrose normal saline. In post operative clinical assessment patients were evaluated for limb salvageability, surgical site infection (SSI), need for surgical debridement, and the day of fasciotomy wound closure post-surgery 30 days

Total 37 patients were enrolled, 19 in group A and 18 in group B. The mean of age (years) of our study population was 29.83 (SD 11.47). Limb salvageability was not significantly different (78.95 % v/s 55.56%, p=0.170). SSSI (P=0.45), need of surgical debridement (p =0.53) and mean days of fasciotomy closure (p=0.05) were also not statistically significant. There was no reported adverse event with NAC.

This study showed NAC safety as an adjunct in acute traumatic limb vascular injuries management. There was improvement in limb salvageability though statistically not significant.