Ladies and Gentlemen,
we are always looking for great stories, Studies to share with you and here is a good one.
A paper in EMJ compares various methods for performing field amputations. I can’t say I ever had to do one myself. However, some of the people I work with have performed amputations on rapidly deteriorating entrapped trauma victims.
Most them have relied on the standard Gigli technique where they scalpel the soft tissues and cut the bone with the Gigli saw. Apparently it is painfully slow, especially as it is performed on a trauma patient that is super sick. One colleague recommends using the firemens’ pneumatic cutters.
Cadaver study comparing four amputation methods. All techniques relied on equipment that is readily available in the prehospital environment.
Time to full amputation of the femoral bone being the primary outcome. Secondary outcomes was the quality of the cut as graded by a home-made scaling system (1= Very poor cut to 5=excellent quality smooth cut with minimal tissue injury).
The classic Gigli technique where soft tissues are cut with a scalpel followed by Gigli-ing the bone.The methods compared were
- Fire service hacksaw.
- Holmatro ‘Jaws of Life’ pneumatic cutters.
- Battery driven reciprocating saw cutting through soft tissue and bone.