Emergency War Surgery NATO Handbook: Part III: General
Considerations of Wound Management: Chapter XXI: Amputations
General Principles
United States Department of Defense
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Reviewed
Certain principles in the management of amputations in the forward
area merit additional emphasis:
- Amputations are performed to save lives.
- Amputations are performed at the lowest possible level of
viable tissue.
- An obviously useless extremity should be amputated as early as
possible.
- There is no ideal or standardized level of amputation in the
forward area.
- All amputations should be left open.
- Cold injury, per se, is not an indication for emergency
amputation.
- During evacuation, continuous traction should be provided to
the amputation stump to prevent skin retraction.
- Patients should be counseled regarding stump and phantom pain.
Adequate medications for stump pain should be provided.
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