OP procedure
A transfemoral amputation is a long and complicated operation, but it can be performed safely due to standardized surgical steps. The operation is always performed under general anesthesia, unless there are medical reasons against it. Various serious heart or lung diseases, for example, speak against general anesthesia.
Directly before the operation, the leg to be amputated is thoroughly disinfected and the rest of the patient is covered with sterile cloths to keep the risk of bacterial infection as low as possible. The patient lies on his or her back during the entire operation. In most cases, the amputation is performed in “bloodlessness”.
This means that a large cuff is placed around the leg and inflated. This compresses and closes the blood vessels. In this way, intraoperative blood loss can be significantly reduced and the surgeon has a better view of the surgical site.
An incision is first made through the skin, then through the soft tissue, muscles, tendons and fat until the bone is exposed. This is cut through with a bone saw and then rounded at the edges to prevent sharp edges from damaging the surrounding tissue later on. Lidocaine is injected into the ends of the nerve fibers that have been cut through.
Lidocaine is a local anesthetic that locally anesthetizes the nerve. This is intended to prevent the occurrence of phantom pain. After cutting through the bone, the soft tissue behind the bone must be removed.
The incision does not go straight through the leg, but slightly oblique. This creates a kind of flap of skin and subcutaneous fatty tissue at the end, which can be folded over the bone stump and has a cushioning function. A drainage is then inserted to drain off any blood that may seep into the wound after the operation.
Finally, the wound is sutured. First the deep structures are sutured and then the skin. For the skin, staples or sutures can be used to close the wound.
