Ablation - a surgical procedure aimed at removing
limb or part thereof, which prevents normal function of a healthy
limbs and, moreover, it causes intractable pain and danger or
the spread of infection. Amputation is used as a last resort
Indications severe damage may be to amputation or
tumor, but most often the cause of amputation are disease of the peripheral
arteries due to atherosclerosis. Atherosclerosis is disturbed blood flow
in the tissues due to narrowing of the lumen of blood vessels. this leads to
tissue cells do not get enough oxygen and nutrients
substance. Most of all this deficit manifests itself in the most remote
heart areas - fingers and toes. Tissue necrosis begins
with these areas of the body. This initially appears pale,
cooling fingers. Then there is a small sore that quickly
increases and becomes black. There is tissue necrosis. acceding
infection worsens the condition of the tissues. The result raises the question of
amputation, since changes in the tissues become
irreversible and delay in operation is fraught with serious complications.
From the history...
Amputation - one of the oldest operations. Hippocrates held
amputation within the dead tissue later Celsus suggested to carry out its
capturing the healthy tissue that would be more appropriate, but in the Middle
century, it was all forgotten. In the XVI century Pare proposed ligation of vessels
instead of cauterization with a hot iron or lower in boiling oil, then
Louis Petit began to cover the stump skin, and in the XIX century Pirogov suggested
The most common surgery is performed amputations for vascular diseases of limbs, tumors and severe trauma.
Vascular diseases - the leading cause of
amputations in people aged 50 years and older, and occupies 90% of all
amputations. Generally, treatment is complicated by cardiovascular disease is
use of antibiotics, removal of infected tissue, appointment
cardiovascular preparations (eg. anticoagulants) and operative
treatment consists in operations such as angioplasty, bypass surgery,
stenting. However, when the listed activities can help
to achieve the desired result, the surgeon has to resort to amputation
as a life-saving measure.
In addition, vascular damage may occur and
heavy (crush, crushed) injuries, deep burns. AT
as a result, there is a lack of blood supply to the tissues
limbs and necrosis. Failure to remove necrotic tissue, it
fraught spread throughout the body and decay products
Amputation used in the treatment of tumors and malignancies, such as osteosarcoma, etc.
Highlights amputation surgery
- Cut out skin - aponeurotic flap
- The muscles are cut with a knife
- Processing periosteum
- sawing bones
- bone sawdust processing.
- Nerve Treatment: the tip is cut off below the ligature razor blade
- Revision stump, excision of nonviable muscle (not reduced, the color of cooked meat).
- Separate ligation of arteries and veins
- The seam on the muscles (except for severe ischemia, gunshot wounds, anaerobic infections)
All amputation, for whatever reason they are not carried out, is carried out in four stages:
- Dissection of the skin and soft tissues
- bone Cutting
- Treatment of wounds, bandaging vessels, nerves truncation
- Closure of wounds
What happens after amputation
Depending on the situation, the patient remains after amputation of from 5 to
14 days. Sutures are removed on the 7-8 th day after the operation. Appointed
antibiotics, analgesics and drugs aimed at the treatment of
atherosclerosis. Some time later appointed physiotherapy.
Usually after amputation question about prosthetics. Approximate dates
Prosthetics are within 10 - 14 days, but ultimately
it depends on situation.
Possible complications after amputation
- Usually, after the amputation of a limb occur in remote way
called phantom pain. This implies that the patient begins
feel their remote end, it starts to hurt, there
the desire to scratch it.
- Necrosis of the skin in the area of the stump. This occurs under the condition of poor blood supply to the tissues of the stump.
- Keloids. This perversely rough broad scar.
The emergence of envy for the most part not on the quality of the operating
the surgeon, and on the predisposition.
- Angiotrofonevroz - this condition occurs when damaged
nerves during amputation. This marked pain in the scar.