Amputations in War

Experiences in World War I demanded an order that no wound should be closed by primary suture. Even with the advent of the sulfonamide derivatives it is not believed that primary suture is safe in extremity surgery under war conditions. This was further proved by reports of infection which followed débridement, the application of sulfanilamide and primary closure of wounds at Pearl Harbor and by reports in theLancetfrom experiences on the Libyan front. All wounds closed by primary suture or tightly packed were found grossly infected when the patients arrived at the base in Egypt. Methods of amputation might be classified as follows: The guillotine or open method: circular or flapless type; flap type. The closed type of amputation (amputations at site of election where flaps are fashioned and closed by primary suture). Repair of the guillotine stump: (a) Plastic closure. (b) Plastic resection. (c)