Amputation

Amputation, the operation of removing a diseased or injured part of the body. In performing an amputation it is essential that the loss of blood should be reduced to a minimum, and that suitable "flaps" should be cut from the healthy skin and tissues, wherewith to cover the bones and secure a satisfactory stump. With the ancients amputation was rarely practised, as it was a most serious undertaking, their methods of checking the bleeding being crude, and limited to the use of hot irons and various styptics. In the modern operation the main artery supplying the part to be removed is compressed, either by means of the finger or with a tourniquet (q.v.), the flaps are then cut, the bone sawn through, and the bleeding vessels are then rapidly secured with artery forceps, and either tied or twisted, the flaps being finally sewn together, and a suitable dressing applied. Thus the haemorrhage is but slight in amount, and even amputation at the hip joint, where the arteries involved are of large size, has become a practicable operation. Occasionally the circular is preferred to the flap method. Here the amputation knife is passed circularly round the limb, the skin having been previously drawn up as far as possible, so that it and the muscles may be "cut long," and so secure a covering for the bone. Whereas in the more usual form of operation the limb is transfixed with the knife and flaps are cut. In amputating at various points a certain definite routine is frequently observed. Thus, Syme's amputation through the ankle joint, Seale's amputation through the leg, and Chopart's and Lisfranc's through the foot, are favourite modes of operating in those particular situations. Previous to the days of anaesthetics rapidity was of essential importance in performing amputation. Nowadays, however, this is happily not a matter of such moment. Again, modern surgery, with its improved methods of treating operation wounds, secures much better results than was the case in earlier days.