Type of Surgery
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Last updated: 11/24/2009
Before an amputation is performed, extensive testing is done to determine the proper level of amputation. The goal of the surgeon is to find the place where healing is most likely to be complete, while allowing the maximum amount of limb to remain...
for effective rehabilitation.
The greater the blood flow through an area, the more likely healing is to occur. These tests are designed to measure blood flow through the limb. Several or all of them can be done to help choose the proper level of amputation.
- measurement of blood pressure in different parts of the limb
- xenon 133 studies, which use a radiopharmaceutical to measure blood flow
- oxygen tension measurements in which an oxygen electrode is used to measure oxygen pressure under the skin (If the pressure is 0, the healing will not occur. If the pressure reads higher than 40mm Hg [40 milliliters of mercury], healing of the area is likely to be satisfactory.)
- laser doppler measurements of the microcirculation of the skin
- skin fluorescent studies that also measure skin microcirculation
- skin perfusion measurements using a blood pressure cuff and photoelectric detector
- infrared measurements of skin temperature
No one test is highly predictive of healing, but taken together, the results give the surgeon an excellent idea of the best place to amputate.
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In an above-the-knee amputation, three incisions are made (A). First the skin and muscle layers are cut (B). The major blood vessels are clamped and severed (C). The bone is cut with a special saw (D). Finally, the muscles are stitched over the bone, and the skin is closed over the wound (E). (Illustration by GGS Inc.)
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Other Information
Amputation is the removal of a body extremity by trauma or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for such problems. A special case is the congenital amputation, a congenital disorder, where foetal limbs have been cut off by constrictive bands. In some countries, amputation of the hands or feet is or was used as a form of punishment for people who committed crimes. Amputation has also been used as a tactic in war and acts of terrorism. In some cultures and religions, minor amputations or mutilations are considered a ritual accomplishment. Unlike many non-mammalian animals (such as lizards that shed their tails), once removed, human extremities do not grow back. A transplant or a prosthesis is the only option for recovering the loss.
Other Information
Orthopedic complaints are the most common reason to seek medical care.
From: About.com
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