AUC Assumptions and Disclaimer

  • Adults (17-64) with high-energy lower extremity trauma (below the knee joint)
  • Consultations with trauma, vascular, and plastic surgeons have been undertaken as necessary
  • Adequate distal perfusion is present or can be restored
  • This AUC only addresses those patients initially admitted to the hospital and prior to definitive wound closure



  • High-energy = Type III fractures, crush or blast injuries, or severe soft tissue degloving injuries
  • Trauma injury = crushed/mangled extremity, burn, muscle loss, bone loss, soft tissue coverage deficit indirect injury, improvised explosive devices (IED), ballistic injury
  • “Advanced/End Stage Comorbidities” include: liver, kidney, heart, lung, peripheral vascular disease (PVD), cancer, neuropathic limb



  • Patients with traumatic amputation
  • Patients in extremis not rapidly correctable due to other systemic injuries and/or polytrauma (i.e. those not able to undergo immediate limb salvage surgery or may need an immediate amputation for survival)

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