Certain injuries to the aorta, vena cava, and long segments of peripheral vessels preclude lateral arteriorrhaphy or primary end-to-end anastomosis. In such cases some type of vascular prosthesis is required. The choice of a suitable vascular prosthesis in potentially contaminated wounds is open to controversy.In the past 5 years, more than 500 patients were seen with vascular injuries at the Ben Taub General Hospital: 122 required prosthetic interpositions to bridge the defect; 57 had Dacron tube grafts; 63 had autogenous saphenous graft interposition. Three had extra-anatomic bypass grafts (Dacron). Among these, 102 wounds were potentially infected, and in 20 there was definite contamination documented at the original operation. Twelve perigraft infections were seen postoperatively, five in patients with Dacron and seven in patients with vein prostheses. Disruption of the entire vein conduit was seen in five patients with vein prostheses resulting in profuse hemorrhage, with two late amputations. Among the five peri-Dacron infections, three had intermittent anastomotic leaking, but no evidence of thrombosis or hemorrhage. There were six early deaths, all secondary to massive blood loss and shock. Two late deaths occurred (at 5 weeks and 12 months).Although the graft infection rate was identical, patients with peri-Dacron graft infections had more easily managed complications than those with infections around an autogenous vein prosthesis. When practical in potentially contaminated traumatic vascular injuries, Dacron appears to be preferable to autogenous vein as a substitute conduit when an extra-anatomic prosthetic routing is not feasible.