Guillotine amputation

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Specializes in Urgent Care.

I was able to assist on a dressing change today of a guillotine amputation to the lower leg. I had no idea physicians amputated this way in this day & age. What an amazing thing to see! I may never see anything like it again. Wow.

We did chemical debridement and wet/dry dressing on it. Tomorrow the pt is due to have a graft over the exposed stump.

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Specializes in geriatric, hospice, med/surg.

What is a guillotine amp? Is it just blunt edged rather than stump roundedness?

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Specializes in Cardiac.

I saw this on a foot once, just at the arch. Weird! It is a little odd, isn't it!

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Specializes in Utilization Management.

I never heard of this technique until this post (although I've had patients who've had this type of surgery), so I Googled it and found a very interesting link on surgical techniques. From this reading, I gather that your patient had a gangrenous foot.

http://www.acssurgery.com/acsonline/chapters/ch0619.htm

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Specializes in Urgent Care.

Picture laying the leg on a guillotine and a big blade just cutting straight through in one fail swoop. Everything on the end is open. The bones were cut and I could see the dark marrow, the ends of vessels where they had been cauterized. Just one big slice.

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Specializes in Urgent Care.
I never heard of this technique until this post (although I've had patients who've had this type of surgery), so I Googled it and found a very interesting link on surgical techniques. From this reading, I gather that your patient had a gangrenous foot.

http://www.acssurgery.com/acsonline/chapters/ch0619.htm

Yes you are correct. The other foot is bad as well, with exposed achilles tendons and all. I don't know how they are going to be able to save it.

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Specializes in LDRP.

Oh. my. goodness.

More impressive is that it didn't totally freak you out.

Dear God, may I never see a guillotine amputation. Thank you! ;)

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Specializes in Urgent Care.

I was actually so fascinated that I didn't even consider getting grossed out or woozy. Plus the patient wasn't having any pain which helped as well.

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Specializes in Neuro.
I was actually so fascinated that I didn't even consider getting grossed out or woozy. Plus the patient wasn't having any pain which helped as well.

As I read your posts describing it, all I could think was "Wow, that'd be pretty neat to look at!" Not so much for the patient, of course.

That's crazy that they leave it open. I guess the skin will eventually grow over the wound to heal secondarily?

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Specializes in Urgent Care.

No, he is actually having surgery in a day or 2 to close it with a graft. That is why I was so lucky to see it still open! :)

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Specializes in Med Surg/Tele/ER.

That is just amazing! I would love to see something like that! The one I saw took forever, but it was pretty neat too.

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I am a junior in nursing school and today in my med/surg rotation, I got to take care of a woman who had just had this procedure done yesterday.. It was unbelievable! We didnt really look into what it meant by guillotine amputation in the chart so we went in to do the dressing change and boy were we shocked when we took the bandages off! My instructor let me do the dressing change with betadine and all that good stuff.. just some background- she was diabetic with several left foot ulcers. She got her foot cut off at the ankle and they left it open because she was going to have to get more cut off after her infection began to get better. It was by far the coolest thing I've ever seen...

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