Operative Note |
PROCEDURE: Above-the-knee amputation. |
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SUMMARY: After satisfactory prepping and draping of the area
the sterile tourniquet was placed at the higher end of the thigh. It was inflated to 300 mmHg. The skin flaps were then
raised in a fishmouth fashion with proposed bone transection at upper 1/3rd of the thigh and the skin incision extending up to the
middle 1/3rd of the thigh. The skin, subcutaneous tissue, and fascia were then incised along the line of incision. All
the muscles were individually transected and visible bleeders were cauterized. The femoral artery, femoral vein, and sciatic
nerve were also identified and they were all doubly ligated and transected. The bone was cut with a Gigli power saw and then
the rest of the muscles in the posterior compartment were also transected. The tourniquet was released and all the minor bleeding
that came from the muscular vessels were also tied. The patient did have open femoral artery and a good blood supply to all
the muscles. So there was quite a bit of muscular blood vessels that we had to tie, but it was systematically done and satisfactory
hemostasis was secured. The fascia was closed with 2-0 Dexon. The skin was approximated with skin staples. Pressure
dressing was applied. The patient was sent to recovery room in good condition.
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