Friday, August 2, 2013

Surgeons frequently treated arm and leg wounds by amputating. The grisly wounds caused by bullets and schrapnel were often contaminated by clothing and other debris. Cleaning such a wound was time-consuming and often ineffective. However, amputation made a complex wound simple. Surgical manuals taught that an amputation should be performed within the first two days following injury. The death rate from these so-called primary amputations was lower than the rate for amputations performed after the wound became infected. Union surgeons performed nearly 30,000 amputations.

Patients undergoing amputation were first anesthetized. A tourniquet was applied above the site of the proposed amputation. The skin and muscle were then cut with amputation knives several inches above the fracture site. The muscles were pulled up to expose the bone. An amputation saw was used to cut through the bone. Once the cut was completed, large arteries were pulled out from the stump tissue with a tenaculum and tied off to prevent bleeding. The skin muscle was then released and the tissue sutured. Two types of amputation were commonly used. A circular amputation involved cutting straight through the skin to the bone and resulted in a stump that was circular in appearance. A flap amputation required the tissue to be cut leaving two flaps of skin that were used to create a stump. Fingers and other small bones were amputated using the smaller metacarpal saw.

Prosthetic limbs were designed and built to help amputees regain some of their former capabilities. Some of these devices were custom-made while others were mass-produced.