Use of Knives and Multitools to Perform a Cadaveric Limb Amputation

Area of Science:

• Emergency Medicine
• Surgical Techniques
• Trauma Care

Background:

• Field amputations are critical life-saving procedures when standard surgical equipment is unavailable.
• Austere environments necessitate evaluating alternative tools for emergent limb amputations.

Purpose of the Study:

• To assess the efficacy of common hand tools in performing rapid (<2 minutes) cadaveric amputations.
• To compare the performance of a multitool, rescue tool, hunting knife, and fixed-blade knife for field amputations.

Main Methods:

• Timed guillotine amputations of extremities were performed on three cadavers.
• Four hand tools were utilized: multitool, rescue tool, hunting knife, and fixed-blade knife.
• Primary outcome measured was successful amputation within the 2-minute timeframe.

Main Results:

• The multitool demonstrated the highest success rate (78%), followed by the hunting knife (67%), rescue tool (56%), and fixed-blade knife (44%).
• Distal tibia/fibula and radius/ulna amputations were successful with all tools, while the femur remained unamputated.
• The multitool received the best subjective ranking from operators (1.4).

Conclusions:

• The multitool is a viable and effective instrument for emergent distal extremity field amputations.
• In situations lacking standard equipment, hand tools can be utilized for life-saving amputations.
• Further research may explore tool optimization for more complex amputations.