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Limb salvage refers to medical or surgical strategies aimed at preserving a limb (typically an arm or leg) that is threatened by trauma, infection, vascular disease, tumor, or non-healing wounds—instead of amputating it. It's a multidisciplinary process involving vascular surgeons, orthopedic surgeons, plastic surgeons, infectious disease specialists, and wound care teams.
In our practice, we will focus on the condition which causes severely reduced blood flow in the lower extremities from atherosclerotic plaque buildup. This is category of disease is called “Chronic Limb Threatening Ischemia”.
🔹 Common Indications for Limb Salvage
- Peripheral arterial disease (PAD) / Chronic Limb Threatening Ischemia
- Diabetic foot ulcers
- Traumatic injuries (e.g., open fractures, crush injuries)
- Malignancies (e.g., osteosarcoma or soft tissue sarcomas)
- Chronic osteomyelitis
- Severe infections (e.g., necrotizing fasciitis)
🔸 Goals of Limb Salvage
- Restore vascular supply
- Control infection
- Achieve soft tissue and bony stability
- Preserve function and mobility
- Enhance quality of life
🔹 Key Components of Limb Salvage Treatment
- Revascularization
For vascular compromise:
- Angioplasty and stenting
- Bypass grafting (e.g., femoral-popliteal bypass)
- Endarterectomy
- Infection Control
- Aggressive debridement
- Targeted antibiotic therapy
- Management of osteomyelitis if bone is involved
- Wound Care & Tissue Coverage
- Negative pressure wound therapy (VAC)
- Skin grafts, local flaps, or free flaps (plastic surgery)
- Growth factors or advanced biologics (in some chronic wounds)
- Rehabilitation
- Physical therapy for mobility and strength
- Custom orthotics or braces
- Psychological support for patient motivation and adjustment
🔸 When Amputation May Be Preferred
- Non-salvageable vascular supply
- Extensive tissue loss or infection
- Poor functional prognosis even after salvage
- Patient comorbidities or inability to tolerate multiple surgeries
- Rapid return to mobility with prosthetics may sometimes outweigh salvage attempts