The limb amputation is a common surgical method not only in military conflicts, but also in times of peace when it is related to complications of diabetes.
The surgical procedure is performed in general anesthesia. The aim of the procedure is to remove a part of an upper or lower extremity. The doctors always try to save as much of the tissues as possible and to remove only the parts that can not be saved. The surgeons work with a number of tools such as surgical scalpels and special saws. The operation includes transversal cut of the affected limb with gradual and progressive division of muscles, bones, nerves and blood vessels. Any bleeding is stopped by ligatures.
At the end of the operation, the remaining tissue is sewn together and the stump is formed. Postoperative care is also very important in adequate rehabilitation and preventing bacterial infection of wounds.
The procedure is performed after severe limb injuries when the injured limb can not be saved. Leg amputations are commonly performed in later stages of diabetic foot, which is a complication of chronic diabetes. Amputation may be the only option in peripheral vascular disease when the leg tissues are damaged by the lack of oxygen and in local acute arterial closure when its treatment has not been quick enough and the tissues got affected by phlegmon or even gangrene. Amputation in these infectious complications can be considered as life-saving as untreated limb infection can easily cause sepsis and circulatory shock. Less common causes of amputation are malignant tumors of the limbs, typically various types of dangerous sarcomas. Last, but not least reason of an amputation could be irreversible damage to limbs due to frostbite. Very rare causes of amputation are pathological conditions such as Buerger's disease and severe forms of Raynaud's phenomenon. Planned amputations are performed in various congenital defects of the limbs, typically in excessive number of fingers. The aim in this case is to correct the defect and to ensure the maximal quality of the limb function.
The main problem is, of course, the loss of a limb, which has an impact on the psyche of the patient and his physical performance. The operation may be followed with feeling of phantom pain. Especially in peripheral vascular disease and in diabetic foot, the stump tissue may be unable to heal and get infected. Repeated amputation may be necessary in such case.
The advantage of amputation in congenital defects is clear. In other cases, we see the amputation as a last resort to treat severe conditions that do not respond to conservative therapy and that endanger the patient's life.