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Temporary Limb Salvage Shunt: A New Tool for Traumatic Limb Amputation

Patients with severe leg injuries often face a difficult choice of whether to have multiple operations to repair their damaged limb or undergo amputation. With advances in medical technology, limb reconstruction has replaced amputation as the primary treatment at many trauma centers.

Amputation is the removal of a body extremity by trauma (also referred to as avulsion) or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for such problems.Types of amputation include; leg,arm,teeth.

The decision to salvage or amputate a severely injured limb is one of the most difficult an orthopaedic surgeon may face.Even surgeons with tremendous trauma experience cannot agree on standard course of action. In the face of such injuries, physician consultation regarding the treatment decision, including all of those members of the team that are needed for a successful salvage, is necessary. In the best circumstances, the trauma surgeon, vascular surgeon, orthopaedist, and a soft-tissue specialist are all involved. The inclination to undertake heroic measures to save the limb should be tempered by the realization that doing so may lead to repeated hospitalizations, extensive complications, and a poor functional outcome.

Method of Amputation :

The first step is ligating the supplying artery and vein, to prevent hemorrhage. The muscles are transected, and finally the bone is sawed through with an oscillating saw. Skin and muscle flaps are then transposed over the stump, occasionally with the insertion of elements to attach a prosthesis. In a disarticulation amputation, the bone is removed at the joint.

U.S. health officials said that they approved a device that could help save the arms and legs of injured soldiers and trauma victims.

The Temporary Limb Salvage Shunt, made by Terumo Corp.'s unit Vascutek Ltd., connects the ends of a severed blood vessel, providing a bridge around the damaged area and restoring blood flow to the injured limb, the U.S. Food and Drug Administration said.

The device can be implanted while the patient is on the battlefield or in a remote area to temporarily maintain blood flow until the patient can be taken to a surgical facility, the FDA added.

The agency said it reviewed the device in less than one week because it met a critical need.

"This device offers surgeons a new tool to potentially avoid the need for limb amputation following traumatic injury," Dr. Daniel Schultz, director of the FDA's Center for Devices and Radiological Health, said in a statement.