Development of A Multispecialty Limb Salvage Protocol With Incorporation Of Long Saphenous Arterial-Venous Loops For Free Flap Reconstruction In The Mangled Lower Extremity

The ability to salvage the mangled lower extremity is both technically challenging and time consuming. It requires the collaborative efforts amongst multiple surgical specialties in addition to comprehensive post-traumatic wound follow-up. Our institution has integrated a dynamic effort amongst these specialists in the planning and facilitating a successful limb salvage program with creation of a mangled extremity algorithm. An integral part in this process is the vascular inflow to prepare coverage for large tissue defects lacking adequate recipient targets. Utilization of a long saphenous arterial-venous loop has been cited with minimal data available with using larger inflow vessels in the acute trauma setting. We describe our early experience using our protocol with arteriovenous loop creation with free flap reconstruction to salvage traumatic leg injuries.