allahyokdinyalan

allahyokdinyalan t1_j9gwc6a wrote

Medical student with expressed interest in surgery here.

Amputation is not simply chopping off a limb. If planned well, it involves several steps of careful surgical interventions.

The most important thing to note about amputations is that, you would want to keep the mobility as high as possible. Depending on the amount of tissue left, you would generally want to keep joints and a bit more tissue distal to the joint.

So let's start with the innermost part, the bone. You would not want to expose the bone or leave a thin layer of tissue around it. That would lead to pain using prosthetics and during daily life even without the use of prosthetics.

In order to prevent this, the surrounding soft tissues, muscle and fat and skin needs to be slightly longer than the bone so that it can cover the bone well enough.

As stated above by a surgeon, directly connecting big arteries and veins leads to poor cardiovascular outcomes. It certainly depends on the type of trauma and the amount of salvagable tissue but you would want to rely on capillaries and angiogenesis (new vessel formation) for venous return in the long run.

There must also be enough skin to cover the resulting "stump" of a tissue without puckering the skin and while trying to achieve the best cosmesis and surgical outcomes.

I have explained all these steps because many people imagine sawing a leg off when someone says amputation but in modern surgical practice, that's far from truth.

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