England flanker Tom Rees will miss the rest of the RBS Six Nations because of injury and winger David Strettle is highly unlikely to feature again.
Tom Rees injured his knee during the Six Nations defeat to Wales
Forward Rees damaged ligaments in his left knee during Saturday's defeat by Wales and faces eight weeks in rehab.
Strettle, who injured a metatarsal in his left foot at Twickenham, will be sidelined for four to eight weeks.
The Harlequins winger will return to see a specialist in three weeks' time for his injury to be re-assessed.
Wasps director of rugby Ian McGeechan said of Rees: "This is very disappointing news, particularly bearing in mind way Tom was playing in Saturday's game and I think his departure had a significant impact on England's performance in the remainder of the game.
"Our medical and rehab team will be working very hard to get Tom back to full fitness as soon as possible."
England have been ravaged by injuries following the game against Wales.
Lewis Moody (Achilles) is unlikely to play against Italy on Sunday, while centre Mike Tindall sustained bruising to his liver and also looks set to miss the rest of the tournament.
The 2003 World Cup winner remains under observation at Hammersmith Hospital.
He had only just returned to the side after missing last year's World Cup following a broken leg.
Head coach Brian Ashton has called up Newcastle scrum-half Lee Dickson, London Irish fly-half Shane Geraghty and Sale flanker Magnus Lund for the game against Italy.