When, in the course of events, the vascular supply to a lower extremity is so severely damaged by disease that gangrene of the toes or the foot results, it is not surprising that the patient's very life is in extreme jeopardy. Frequently the disease involves the entire vascular system. There is often impairment of function of certain vital organs, notably the heart and kidneys. Procrastination of removal of the dead part invites further bodily injury from pain, infection and toxic absorption. One cannot fail to be impressed by the hazards facing these aging individuals with vascular gangrene, nor can one ignore the sad plight in which the surgeon often finds himself in attempting to relieve the situation. Surgery is a precarious undertaking, for amputation must be performed at a sufficiently high level to insure healing of the stump. Uniformly the higher the site of the amputation, the greater the mortality
VEAL JR. THE PREVENTION OF PULMONARY COMPLICATIONS FOLLOWING THIGH AMPUTATIONS: BY HIGH LIGATION OF THE FEMORAL VEIN. JAMA. 1943;121(4):240–244. doi:10.1001/jama.1943.02840040016005
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