Author(s)

Samantha A. Delapena¹, Luis G. Fernandez², Devin O’Connor¹, Katharine A. Dishner³, Marc R. Matthews^4*

¹St. Joseph’s Medical Center/Valleywise Health Medical Center, Creighton University, Phoenix, Arizona, USA.
²University of Texas, Health Science Center, Tyler, Texas, USA.
³Dartmouth College, Hanover, New Hampshire, USA.
⁴University of Arizona and Creighton University Schools of Medicine, Phoenix, Arizona, USA.

A physiologic amputation is an important option for the critically ill patient who has irreversible limb disease with necrotic wounds but who would have a low probability of surviving a standard open amputation, without effective preoperative resuscitation, antibiotics, and correction of metabolic derangements. An open amputation may be required secondary to vascular ischemic disease, necrotizing fasciitis, or thermal injury that has led to the critical and unstable condition. The physiologic amputation stabilizes the patient while preventing further metabolic deterioration. The cryoamputation is intended to rescue the patient’s life and is not meant for limb salvage. While physiologic amputation has been described for over a century, it is uncommonly performed. This case report describes a physiologic amputation in a step-by-step fashion for the surgeon attempting to save a critically ill patient’s life who might not otherwise survive an open amputation.

Physiologic Amputation, Cryoamputation, Critically Ill, Sepsis, Septic Shock, Cryoanesthesia Amputation, Medical Amputation

Delapena, S. , Fernandez, L. , O’Connor, D. , Dishner, K. and Matthews, M. (2022) Is the Critical Patient with a Septic Limb Too Sick for an Emergent Amputation? A Case Report Illustrating How to Perform a Bedside Physiologic Amputation. Surgical Science, 13, 222-233. doi: 10.4236/ss.2022.134028.