It is only possible in cases where there is no arterial injury or fracture and only soft tissue injury.
The patient has to be first stabilized by giving fluids and fully resuscitated. His cardiac condition must be improved if it is compromised. If he is a diabetic his sugar must be brought under control. His electrolytes have to be corrected before surgery. Always remember “Life is more important than limb”. You do not want to rush into surgery and lose an unstable patient.
The golden period is six hours after which the muscles of the limb start to go into irreversible damage and as time goes no it becomes progressively more difficult to save a limb.
If there is a fracture it has to be stabilized before the blood supply is restored. This could be by external fixation if the wound is open or an internal fixation if there is no open wound but the surgeon may prefer external fixation.
This is by repair of the vessel or a bypass. The original anatomy is restored by joining the cut ends.
At times a patch may be used to cover the hole in the artery.
or if the gap is too much then graft from the patient’s body or from outside is put between the cut ends to restore the circulation.
If the facility of repair of the vessel is not available in your área and the center where it is available is quite far away then an attempt to salvage can be made by doing a fasciotomy. Here the tense skin is cut to remove the pressure on the injured vessels. This is only an attempt to save the limb.
Content Reviewed by – Dr. Jaisom Chopra