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Revascularization of the Mangled Limb

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The Mangled Extremity

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Abstract

Critical ischemia, defined as arterial inflow interruption with imminent anoxic tissue necrosis, is an absolute surgical emergency. Efforts at restoring perfusion are second only to more urgent critical trauma to the vital organs. Returning arterial flow can be accomplished via direct arterial repair, synthetic conduit shunt, synthetic graft, and autologous graft. Regardless of technique, consideration must be given to the timing and technique of skeletal stabilization to preserve the structural integrity of the vascular repair or reconstruction. Prophylactic fasciotomy must be considered in the setting of critical ischemia, particularly of the lower limb, to mitigate risk of compartment syndrome secondary to swelling which invariably accompanies reperfusion injury. Finally, advanced soft tissue (flap) coverage may be required to prevent dehiscence and compromise of the reconstruction.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Rutgers University, Newark, NJ, USA

    Naji Madi

  2. R Adams Cowley Shock Trauma Center, 22 South Greene St, Baltimore, MD, 21201, USA

    Ray Pensy

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  1. Naji Madi
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  2. Ray Pensy
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Correspondence to Naji Madi .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA

    Raymond A. Pensy

  2. Hand Surgery Division Department of Orthopaedic Surgery, Sinai Hospital of Baltimore, Baltimore, MD, USA

    John V. Ingari

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Madi, N., Pensy, R. (2021). Revascularization of the Mangled Limb. In: Pensy, R.A., Ingari, J.V. (eds) The Mangled Extremity. Springer, Cham. https://doi.org/10.1007/978-3-319-56648-1_5

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  • DOI: https://doi.org/10.1007/978-3-319-56648-1_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56647-4

  • Online ISBN: 978-3-319-56648-1

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