Transposition of an arterial segment from a traumatically amputated lower limb to treat an upper limb vascular lesion on a multi injured patient as an alternative technique for trauma patients

Trauma is a public health problem that throughout the world. Extremity vascular injuries need special consideration for they threaten limbs and lives [16] and [6].

Blunt trauma has worse prognosis and higher amputation rates, when compared to penetrating vascular injuries, for civilian and military wounds [16], [3] and [1].

Repair can be achieved by lateral sutures, but more often the traumatized vessel requires excisions and end-to-end anastomosis. If a “tension free” anastomosis is not possible a graft interposition is indicated, using an autogenous vein if possible [16], [17], [9], [14] and [10] or a prosthesis, that have a greater risk of infection and inferior patency rates when compared to autogenous ones, which is an important consideration in young injured patients with long life expectancies [14].

The quest for autogenous conduits in the multi injured patient can be challenging and an amputated limb can provide an important source of autologous conduits [10] and [11].

In Iraq, reversed saphenous grafts from contralateral amputated lower limbs were used to reconstruct injured arteries and veins of the remaining lower extremity [10] and [11].

To the best of our knowledge, however, the transposition of an arterial segment from a traumatically amputated lower limb to treat an upper limb arterial injury has not been previously reported. This option may be associated with important benefits when compared to the saphenous alternative for trauma patients.

The aim of this article is to describe the utilization of an arterial segment removed from a traumatically amputated lower limb as an autologous graft to treat an axillary artery injury on a multi injured patient.