Prosthetic vascular graft and autogenous vein graft with free-tissue transfer in attempted lower-limb salvage

Chronic wounds of the lower extremity are frequent causes of osteomyelitis and amputation in patients with peripheral vascular disease. Advances in vascular surgical techniques, allowing distal arterial bypass via synthetic grafts or autogenous vein grafts, have significantly increased the frequency of limb salvage. In the last two decades, this increasing success has contributed to an even greater rate of extremity salvage. The authors report a case of attempted limb preservation, using a combination of macrovascular polytetrafluoroethylene (Goretex) grafting, reverse saphenous vein interposition, and vein-patch angioplasty, to facilitate microvascular free-tissue transfer.