Prehospital amputation: An experimental comparison of techniques

Area of Science:

• Emergency Medicine
• Surgical Techniques
• Trauma Care

Background:

• Prehospital limb amputation is a rare, life-saving intervention for patients with limb entrapment or hemodynamic compromise.
• Emergent amputation may be necessary when prolonged extrication is not feasible.

Purpose of the Study:

• To experimentally compare the efficacy of three prehospital amputation techniques.
• Evaluate amputation time, instrument malfunction, and cut cleanliness in porcine models.

Main Methods:

• Three techniques were tested: scalpel with Gigli saw, hacksaw, and reciprocating saw.
• Each technique was performed three times by an emergency physician, paramedic, and medical student on porcine legs.
• Primary outcome was amputation time; secondary outcomes included instrument malfunction and cut cleanliness.

Main Results:

• Reciprocating saw (2.84 ± 0.40 s) and hacksaw (6.28 ± 0.76 s) techniques were significantly faster than the Gigli saw (32.86 ± 16.53 s).
• The Gigli saw technique experienced instrument malfunction in 3/9 trials.
• No significant differences in cut cleanliness were observed between techniques.

Conclusions:

• Hacksaw and reciprocating saw are superior for prehospital limb amputation due to speed and reliability.
• These tools offer faster completion times and fewer malfunctions in time-sensitive scenarios.