Is the Critical Patient with a Septic Limb Too Sick for an Emergent Amputation? A Case Report Illustrating How to Perform a Bedside Physiologic Amputation
Open Access
- 1 January 2022
- journal article
- research article
- Published by Scientific Research Publishing, Inc. in Surgical Science
- Vol. 13 (04), 222-233
- https://doi.org/10.4236/ss.2022.134028
Abstract
A physiologic amputation is an important option for the critically ill patient who has irreversible limb disease with necrotic wounds but who would have a low probability of surviving a standard open amputation, without effective preoperative resuscitation, antibiotics, and correction of metabolic derangements. An open amputation may be required secondary to vascular ischemic disease, necrotizing fasciitis, or thermal injury that has led to the critical and unstable condition. The physiologic amputation stabilizes the patient while preventing further metabolic deterioration. The cryoamputation is intended to rescue the patient’s life and is not meant for limb salvage. While physiologic amputation has been described for over a century, it is uncommonly performed. This case report describes a physiologic amputation in a step-by-step fashion for the surgeon attempting to save a critically ill patient’s life who might not otherwise survive an open amputation.Keywords
This publication has 17 references indexed in Scilit:
- Damage Control Resuscitation: The New Face of Damage ControlThe Journal of Trauma and Acute Care Surgery, 2010
- Incidence of Lower-Limb Amputation in the Diabetic and Nondiabetic General PopulationDiabetes Care, 2009
- Physiologic Amputation Prevents Myoglobinuria From Lower Extremity MyonecrosisSouthern Medical Journal, 1993
- Physiologic Amputation: Preliminary Cryoamputation Of The Gangrenous ExtremityAORN Journal, 1991
- Current role of cryoamputationThe American Journal of Surgery, 1991
- One-stage versus two-stage amputation for wet gangrene of the lower extremity: A randomized studyJournal of Vascular Surgery, 1988
- Below-knee physiologic cryoanesthesia in the critically ill patientJournal of Vascular Surgery, 1988
- Dry ice cryoamputation: A twelve-year experienceJournal of Vascular Surgery, 1985
- An improved technic for freezing the gangrenous extremity in poor risk patientsThe American Journal of Surgery, 1972
- REFRIGERATION IN CLINICAL-SURGERYAnnals of Surgery, 1944