This is a question near and dear to my heart--there is no reason whatever to repair the superficial femoral vein in your case, as it adds virtually no benefit to justify the extensive additional time and complexity of repair it would require. As ageneral rule of thumb, any extremity vein requiring anything more than lateral suture or end to end anastomosis should be ligated, which can be done with virtual impunity in the absence of associated soft tissue or bony injury. Most venous injuries are from penetrating agents, and most are found on exploration for bleeding--only 10-15% are isolated without a concomitant arterial injury. The series out of Vietnam by Rich dealt with high velocity wounds and a high incidence of bone and soft tissue destruction, destroying venous collaterals and impairing drainage if ligation was done. The overwhelming bulk of civilian literature since Vietnam clearly demonstrates the safety and preference of ligation (see refs below), which the consensus agrees should be done in any unstable patient or for wounds with large vessel length lost as in this case. The incidence of post op venous insufficiency is at least as low as if veins were repaired as a rule, and when it happens is easily managed by limb elevation and generally resolves. Patients with these injuries have typically lost a lot of blood, present in shock, and frequently have associated injuries that do not warrant the extra time necessary for complex repairs. If the popliteal vein is injured, we generally try a little harder to fix, sometimes even with autogenous interposition, but even here can be ligated pretty safely--in this case, we would tend to do a prophylactic fasciotomy, or at least monitor compartment pressures closely postop--fasciotomy is also indicated for any combined vein and artery injury. In the upper extremity, any repair of a vein should be considered a tour de force by someone who obviously has a lot of time to kill.