BELOW THE KNEE AMPUTATION

Operative Technique

Patient supine under SAB/CLEA/General Anesthesia

Asepsis and antisepsis technique

Sterile drapes placed

Incision made creating Long Posterior Flap carried from skin through subcutaneous tissue

Superficial vessels ligated

Anterior muscle group cut; bleeders ligated

Anterior tibial vessels individually identified, divided and doubly ligated

Deep peroneal nerve ligated proximally

Lateral muscle group cut; bleeders ligated

Posterior tibial vessels identified at the posteromedial aspect of tibia, individually identified and doubly ligated

Posterior tibial nerve highly ligated

Periosteum of tibia-fibula elevated

Tibia-fibula individually cut with Giggli saw

Fibular vessels identified individually, divided, and ligated

Posterior muscle group cut; bleeders ligated

Edges of tibia-fibular stump bone filed

NSS wash

Hemostasis

Posterior myofascial flap sutured with the anterior myofascial flap by figure of eight vicryl 0 sutures

Subcutaneous tissue approximated with inverted T sutures using chromic 2.0

Skin closed interruptedly using nylon 4.0

Dry sterile dressing applied.