H. Werman, A. Zielinski, and B. Raetzke, The Ohio State University, Columbus, OH J. Nappi, Riverside Methodist Hospital, Columbus, OH Introduction: Patients sustaining limb-threatening injuries must undergo time-sensitive surgical repair in order to achieve maximal functional recovery. Air medical transport has been used to transport patients with these injuries from the scene of injury (SCENE) where short time intervals are achieved as well as from outside medical facilities (HOSP) following physician evaluation. It is not clear which strategy produces best outcomes. We sought to evaluate whether there was a difference between SCENE or HOSP in the percentage of patients taken to the operating room for definitive repair. Methods: All patients with isolated limb-threatening injuries between January 1, 2006 and July 31, 2010 who were transported by helicopter to a tertiary limb-salvage center were included in the analysis. Demographic data including age, gender, injury site and prior medical history were obtained. Patients were dichotomized between SCENE and HOSP with regards to site of origin. Outcomes including discharge from ED, those taken to OR and those who underwent formal salvage procedure were collected. A chi square analysis was conducted to determine whether there was a difference between SCENE and HOSP in the percentage of who underwent definitive repair. Results: During the study period, 115 patients were transferred for limb salvage by helicopter. 86% of patients were male with an average age of 43.3 years (6-86 years). Sixty (52.2%) of patients were HOSP while 55 (47.8%) were SCENE. The upper extremity was involved in 72.9% of cases. Complicating medical factors included diabetes (9.6%), tobacco use (19.2%) and anticoagulant use (16.7%). No patient had documented peripheral vascular disease or steroid use. Of 115 patients, 104 went to the OR (90%) and 84 (80%) had a repair attempted. 41/49 (84%) of SCENE and 43/55 (78%) of HOSP had a definitive repair attempted (p 0.48). Conclusion: In our referral area, a significant number of patients transferred in to a tertiary center for limb-salvage procedures underwent definitive repair in the OR. There was no significant difference between those patients transported after ED assessment when compared to those transported directly from the scene. Further studies should evaluate whether SCENE transfer is both a cost-effective and time-saving strategy for limb-salvage patients.