Amputations of the Lower Extremity
This procedure is still viewed as a failure to the treatment and sadly, at times, the responsibility for performing such an intervention will come to the junior of the medical team. Society views the amputation of a member as a failure but at the same time, within the medical field it not viewed as the worst solution due to the advantages that it ay have on the human body and its health. Amputations can be performed in treating vascular disease, tumors and severe trauma.
This procedure is dated back to pre historical times. Cave wall findings suggest that Neolithic humans survived amputations and loss of digits and mummies have been buried with some replacements of their amputated extremities, being believed that one should return to the other world as it came in this one.
One of the first literatures that describe amputation will be found in the Babylonian code of the Hammurabi, which is inscribed in stone and dates back to 1700 BCE and it can be seen at the Louvre. Plato also describes in his Symposium the therapeutic approaches on amputation of the foot and of the hand and Hippocrates has provided the first description in treatment in his De Articularis for vascular gangrene. The approach was to amputate on the edge of the ischemic tissue and to leave the wound open to allow healing with the help of secondary intent.
There were also described the main risks of sepsis, shock and hemorrhage and before the discovery of the anesthesia, this type of procedures was one of the most difficult to perform due to the large amount of pain that the patient would feel. The patient would be held down by a few people and he or she would be given large amounts of alcohol, most commonly rum to try and numb him or her out.
Sadly, in most cases the patient would be awake and very aware of the procedure, leaving with some emotional damage along the way that has been studied later on in history. This is one of the challenges that amputations will present to a person. Overcoming the loss of a limb comes with a great deal of emotional pain and trying to change the living style would become a challenge for every patient. Due to this, prosthesis have been developed in trying to help the person to cope easier with day to day activities and to overcome the loss that he or she has suffered.
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