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compresses the limb between heartbeats the compression helps cure the wounds in the walls of veins and arteries and helps to push the blood back to the heart 80 for victims of trauma advances in microsurgery in the 1970s have made replantation of severed body parts possible the establishment of laws rules and guidelines and the employment of modern equipment help protect people from traumatic amputations 81 prognosis edit the individual may experience psychological trauma and emotional discomfort the stump will remain an area of reduced mechanical stability limb loss can present significant or even drastic practical limitations 82 a large proportion of amputees from 50 to 80 to 80 100 according to different studies experience the phenomenon of phantom limbs 83 84 they feel body parts that are no longer there these limbs can itch ache burn feel tense dry or wet locked in or trapped or they can feel as if they are moving some scientists believe it has to do with a kind of neural map that the brain has of the body which sends information to the rest of the brain about limbs regardless of their existence phantom sensations and phantom pain may also occur after the removal of body parts other than the limbs e g after amputation of the breast extraction of a tooth phantom tooth pain or removal of an eye phantom eye syndrome a similar phenomenon is an unexplained sensation in a body part unrelated to the amputated limb it has been hypothesized that the portion of the brain responsible for processing stimulation from amputated limbs being deprived of input expands into the surrounding brain phantoms in the brain v s ramachandran and sandra blakeslee such that an individual who has had an arm amputated will experience unexplained pressure or movement on his face or head 85 in many cases the phantom limb aids in adaptation to a prosthesis as it permits the person to experience proprioception of the prosthetic limb to support improved resistance or usability comfort or healing some types of stump socks may be worn instead of or as part of wearing a prosthesis 82 another side effect can be heterotopic ossification especially when a bone injury is combined with a head injury the brain signals the bone to grow instead of scar tissue to form and nodules and other growth can interfere with prosthetics and sometimes require further operations this type of injury has been especially common among soldiers wounded by improvised explosive devices in the iraq war 86 due to technological advances in prosthetics many amputees live active lives with little restriction organizations such as the challenged athletes foundation have been developed to give amputees the opportunity to be involved in athletics and adaptive sports such as amputee soccer 87 nearly half of the individuals who have an amputation due to vascular disease will die within 5 years usually secondary to the extensive co morbidities rather than due to direct consequences of an amputation this is higher than the five year mortality rates for breast cancer colon cancer and prostate cancer 88 of persons with diabetes who have a lower extremity amputation up to 55 will require amputation of the second leg within two to three years 89 medieval and early modern europe edit amputations in medieval and early modern europe were mainly the result of warfare disease work accidents and punishment amputations were performed by barber surgeons 90 disease edit one of the major causes of amputation in medieval europe was disease ergotism also known as saint anthony s fire was a fungus found in rye that caused gangrene that spread from the fingers and toes if the tissue death from the disease was severe enough the limb would spontaneously fall off on its own without blood loss 91 warfare edit warfare amputations became more necessary in europe after european armies started using guns in the fourteenth century at the time bullet wounds were often too complicated for surgeons to handle and amputation was their best solution 92 in the late fifteenth century we see more documentation of amputations as hieronymus brunschwig and hans von gersdorff both illustrated amputation scenes with the latter also writing about gunshot injuries 93 gersdorff s writings showed that surgeons at the time struggled with whether the gunpowder on the wound further worsened the injuries therefore it was a common practice to cauterize the wounds with hot oil until ambroise paré discovered that this impeded healing and concluded that gunshot wounds should not be cauterized this led to another significant contribution of his to warfare medicine the revival of ligature which replaced cauterization of amputation wounds paré updated ligature to make safer and it became common practice 94 amputation as punishment edit there is evidence of amputation as punishment dating back to 1750 bce the babylonian code of king hammurabi sanctioned amputation as a punishment amputation as a punishment continued in ancient peru where the part of the body amputated had a connection to the crime committed for example stealing might be punished by amputating the hand of the guilty amputation continued as a form of punishment into the roman period as well as the byzantine period but became less prominent after the collapse of the byzantine empire these punishments increased again during the middle ages but declined again after perceptions of punitive amputation changed significantly during the renaissance and enlightenment 95 in medieval england corpses would sometimes be amputated after death as a form of public shaming or punishment 96 this would ve been especially meaningful at the time as the state of the physical body after death was significant to medieval christians additionally archaeologists found evidence of postmortem decapitation from medieval times which some speculated to be related to rituals or where the soul goes after death there is also documentation of nose amputation being used as a form of punishment or retaliation in france during the 5th and 6th centuries nose cutting was prominent enough to be classified as its own crime which would result in a serious fine to the perpetrator however it was also occasionally used as a punishment for serious crimes such as threatening royals 97 the field of plastic surgery was brought to europe specifically catania in the fifteenth century when gustavo branca successfully completed an ancient indian method of reconstructive rhinoplasty plastic surgery continued to grow as a field across the continent and the birth of this field is likely related to nose amputation as punishment 98 theories on amputation edit in medieval europe amputation was done on limbs as a last resort when the limb could not be saved for limbs that were dead or decaying surgeons categorized them into two main categories hot fire and cold fire hot fire also called gangraena was the first stage of a decaying limb a body part with hot fire was hot swollen and painful if not treated the limb would turn cold cold fire also called sphacelus was the late stage of limb death including death of the bone symptoms included loss of feeling coldness and black and blue coloring with time the fire would spread and eventually kill the patient 99 followers of galen considered hot and cold fire to be based on the humors and an imbalance of hot wet dry and cold in the body followers of paracelsus believed that hot and cold fire were a result of mercury sulfur and salt while different surgeons drew from different medical theories of the time they also used their own experiences to determine the root cause of the fires there was often debate on whether a particular patient had cold or hot fire which led to disagreements on treatment methods 99 treatment for hot fire often included burning or cutting out damaged flesh if the symptoms were mild enough the skin could sometimes be regrown treatment for cold fire included removing the dead flesh and likely amputation 99 amputation methods edit throughout europe there were varying approaches when it came to amputations the two main considerations for amputation procedures were how fast it could be performed and how it would heal the mallet and wedge technique involved setting the body part on a wedge and hitting the wedge with a mallet this separated the limb or digit from the body by crushing it this method was very fast but left a messy result that caused the crushed bones to splinter into the remaining part of the limb the hand s width method used a curved knife to cut through the limb s tissue and a bow frame saw to cut through the bone an assistant would pull the flesh upwards to expose the bone after the limb was sawed off the flesh would then be pulled back over the stump to create a cushion this procedure took longer but healed more easily 100 one method to stop hemorrhaging after amputation was iron cautery this involved taking hot iron instruments to the new stump and burning off the exposed tissue closing the blood vessels another method of cauterization was to apply corrosive chemicals to the fresh wound to burn the blood vessels and stop the bleeding both methods were efficient but led to a long healing process a different method was ligation this technique required the surgeon to draw out the individual blood vessels and tie them shut this process was much more time consuming but healed more quickly 100 there was also debate among barber surgeons on the location of amputation one rationale was to amputate as close to the damage as possible to save as much of the remaining limb as possible others argued to amputate in a location that would fit a prosthetic the best this was especially debated for lower leg amputation because a prosthetic would fit better if the leg was amputated closer to the knee 100 paré is the first known surgeon to decide the location of an amputation based on how a prosthetic would fit on it in 1564 90 prosthetics edit prosthetics in the early modern period were made from wood metal and leather the majority of prosthetic artifacts from the period still around today were made of metal in germany metal mechanical hands were made with ratchets and springs the springs allowed for movement of the fingers while the ratchets locked them in place the wearer was able to control the fingers by releasing the ratchets through buttons or levers depending on the hand the specific mechanics of the hand varied by prosthetic 101 mechanical prosthetics were the work of artisans specifically locksmiths and clockmakers this was because locksmiths and clockmakers were already using springs and ratchets to make locks doors and clocks 101 etymology edit the word amputation is borrowed from latin amputātus past participle of amputāre to prune back a plant prune away remove by cutting unwanted parts or features cut off a branch limb body part from am assimilated variant of amb about around putāre to prune make clean or tidy scour wool the english word poes was first applied to surgery in the 17th century possibly first in peter lowe s a discourse of the whole art of chirurgerie published in either 1597 or 1612 his work was derived from 16th century french texts and early english writers also used the words extirpation 16th century french texts tended to use extirper disarticulation and dismemberment from the old french desmembrer and a more common term before the 17th century for limb loss or removal or simply cutting but by the end of the 17th century amputation had come to dominate as the accepted medical term 102 notable cases edit without prosthesis edit rick allen bethany hamilton with prosthesis edit götz of the iron hand jessica long sarah reinertsen other edit patch adams douglas bader carl brashear lisa bufano roberto carlos tammy duckworth kalamandalam sankaran embranthiri terry fox zach gowen pete gray shaquem griffin robert david hall hugh herr frida kahlo ronnie lott hari budha magar aimee mullins oscar pistorius amy purdy aron ralston hans ulrich rudel luiz inácio lula da silva henri de tonti alex zanardi lev yashin see also edit acrotomophilia adapted automobile flail limb robotic prosthesis control references edit fathi nazila january 11 2008 spate of executions and amputations in iran the new york times retrieved june 27 2021 chuback jennifer e march 2005 whitelaw w a ed the history of rhinoplasty 14th annual history of medicine days calgary alberta canada university of calgary pp 10 15 via researchgate kocharkarn w summer 2000 traumatic amputation of the penis pdf brazilian journal of urology 26 385 389 archived pdf from the original on october 9 2022 via official journal of the brazilian society of urology peters r 2005 crime and punishment in islamic law theory and practice from the sixteenth to the twenty first century cambridge university press isbn 978 0 521 79226 4 bosmia an griessenauer cj tubbs rs july 2014 yubitsume ritualistic self amputation of proximal digits among the yakuza journal of injury and violence research 6 2 54 56 doi 10 5249 jivr v6i2 489 pmc 4009169 pmid 24284812 kepe t march 2010 secrets that kill crisis custodianship and responsibility in ritual male circumcision in the eastern cape province south africa social science medicine 70 5 729 735 doi 10 1016 j socscimed 2009 11 016 pmid 20053494 grisaru n lezer s belmaker rh april 1997 ritual female genital surgery among ethiopian jews archives of sexual behavior 26 2 211 215 doi 10 1023 a 1024562512475 pmid 9101034 s2cid 32053425 amputator merriam webster retrieved june 28 2021 amputee merriam webster retrieved june 28 2021 maloney t r dilkes hall i e vlok m 2022 surgical amputation of a limb 31 000 years ago in borneo nature 609 7927 547 551 bibcode 2022natur 609 547m doi 10 1038 s41586 022 05160 8 pmc 9477728 pmid 36071168 pinzur ms stuck rm sage r hunt n rabinovich z september 2003 syme ankle disarticulation in patients with diabetes the journal of bone and joint surgery american volume 85 9 1667 72 doi 10 2106 00004623 200309000 00003 pmid 12954823 ransom cliff july 24 2003 did climber have to cut off arm to save life national geographic archived from the original on january 6 2019 retrieved january 5 2019 müller sabine january 5 2009 body integrity identity disorder biid is the amputation of healthy limbs ethically justified the american journal of bioethics 9 1 36 43 doi 10 1080 15265160802588194 issn 1526 5161 pmid 19132621 a b c panchbhavi vinod k june 8 2021 guillotine ankle amputation medscape abdul w hickey b wilson c april 2016 lower extremity compartment syndrome in the setting of iliofemoral deep vein thrombosis phlegmasia cerulea dolens and factor vii deficiency bmj case reports 2016 bcr2016215078 doi 10 1136 bcr 2016 215078 pmc 4854131 pmid 27113791 ragnarsson kristjan t thomas david c 2003 cancer of the limbs holland frei cancer medicine 6th edition bc decker retrieved january 9 2024 frostbite nhs uk october 19 2017 retrieved june 29 2022 a b handford charles 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