In reconstructions after severe traumatic injuries of the lower extremity, free tissue transfers are essentially used to cover the defects and accepted as extremity saving procedures. When major vessels of the lower extremity are patent or uninjured, these vessels can be used for anastomoses in free tissue transfers, however, in some injuries, only one major vessel remains intact and concomitant endothelial damage might also be present in this vessel. In such cases, since the nourishment of the extremity is dependent on this single vessel, its use as a recipient vessel may be risky for the perfusion of the extremity. In such cases, bringing an additional and healthy recipient vessel to the field is a useful option. Loop vein grafts are normally created by vascular surgeons for dialysis patients, and reconstructive surgeons often do not have much experience in this procedure. In this study, it was aimed to give information about the decision making progress that we used during and after the operation by presenting a 32-year-old case who had been admitted with a mangled extremity severity score (MESS) score of seven and a Gustilo-Anderson Type 3C lower extremity injury after a traumatic motorcycle accident injury. It is considered to be helpful for our colleagues who have not used loop grafts in reconstructive microsurgery operations before.
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