by Phil Hay Kevin Blackwell's squad is on the verge of breaking point ahead of Sunday's difficult trip to Wearside.
The Leeds United manager will be forced to drastically restructure his midfield at Sunderland after his absentee list increased during the clash with Millwall last weekend.
Sean Gregan and Simon Walton received their fifth cautions of the term, earning both players a one-match ban, and winger John Oster – on loan from the Black Cats – has been refused permission to face his parent club.
Blackwell's concerns have been offset slightly by the return of Matthew Spring from a damaged hip and he should start in the centre of midfield alongside Jermaine Wright.
The disruption may also allow Julian Joachim back into the starting line-up for the first time since the 2-1 home defeat to Burnley at the start of November, and he is expected to fill the vacancy on the right wing.
Blackwell said: "It's not fitness that worries me. It's whether we can put the strength of side out to give us the edge to win games.
"Clearly Sean Gregan, Simon Walton and Johnny Oster will be big losses against Sunderland but the others that are going to come in will put on a good show."
Centre-back Clarke Carlisle is fully fit after an ankle problem and was named on the bench against Millwall, but Blackwell confirmed that Matthew Kilgallon will hold his place alongside captain Paul Butler.
The youngster has impressed since stepping into the breach and Blackwell said: "To me, as a manager, competition for places is absolutely crucial.
"That gives you an edge within your club and the one place where everyone knew we had competition was centre-half.
"Michael Duberry started and Clarke forced his way in, and Clarke's been superb for most of the season.
"But now Killa's forced his way in and he's been superb – that's what you're looking for."
LEEDS (from): Sullivan, Kelly, Butler, Kilgallon, Richardson, Joachim, Wright, Spring, Pugh, Deane, Healy, Carson, Carlisle, McMaster, Lennon, Ricketts, Keogh, Winter.