Factors associated with increased risk of limb loss following vascular trauma:
(1) delay in treatment (> 6 hours)
(2) blunt mechanism of injury
(3) injury to lower extremity, especially the popliteal artery
(4) injury involving other structures such as nerve, vein, bone, and/or soft tissue
(5) high velocity gunshot wounds
(6) close range shotgun wounds
(7) pre-existing atherosclerotic disease
(8) delay or failure to perform fasciotomy after development of a compartmental syndrome
where:
• The risk of limb loss would seem greater for an arterial lesion than venous injury.
• Many of these factors are associated with the mangled limb syndrome (see below).
Some additional factors not listed in the reference:
(9) poor application of a tourniquet
(10) hypercoagulable state
(11) severe, uncontrolled infection (gas gangrene, etc.)
