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September 1961

Limb Salvage Through Small-Vessel Surgery

Author Affiliations

From the Departments of Surgery of the University of Louisville Medical School and the Jewish Hospital.

Arch Surg. 1961;83(3):414-421. doi:10.1001/archsurg.1961.01300150088011

Introduction  William Stewart Halsted,9 speaking in another context, stated, "One of the chief fascinations of surgery is the management of wounded vessels...." Until recently, a frequent sequela to almost any serious injury of a major artery was loss of the extremity. Reported amputation rates following early ligation of major arteries vary from 45% to 100% in the case of the popliteal artery.5,12,13,17 In recent years, considerable attention has been paid to the principles of reconstructive treatment of major arterial injuries.11-13 Somewhat less well appreciated and considerably more subtle are the injuries to the minor arteries, which can and do threaten the viability of the involved extremity. Jahnke and Seeley13 report an amputation rate of 11.6% for 43 war injuries to the minor arteries, higher than their rate for major vascular injuries. They stated with respect to war injuries, "Little improvement can be expected in the treatment