Complex limb trauma requiring revascularization: early multidisciplinary management

Salvage of limbs with combined vascular, skeletal and extensive soft tissue injury requires the skills of several surgical specialities. Four illustrative cases are presented, three successes and one failure, and from these some conclusions are drawn. Contrary to accepted teaching, it is believed that in the emergency management of most patients with complex limb trauma, vascular reconstruction should take priority, followed by skeletal stabilization, soft tissue repair and early flap cover.