Vascular injuries about the knee in high-energy war injuries

Vascular repair or reconstruction in the military theater can be a challenging undertaking in those patients presenting with an ischemic injury from the battlefield. The military has a long history of caring for these complex war injuries and implementing progressive treatment algorithms and technology to optimize outcomes. Surgeons caring for these individuals must always take the entire patient into account, as attempting to save a limb of an unstable patient can sometimes place the patient's life at risk. In addition, difficult decisions are frequently encountered in patients with mangled extremities in which revascularization procedures might remain viable, but result in a dysfunctional limb that the patient later requests to be amputated. Current evolving promising techniques include earlier resuscitation measures and vascular shunting techniques.