Background
Field amputations are sometimes required to extricate patients from the scene of an injury. It is not uncommon that traditional surgical equipment is neither available nor ideal, especially for cutting through bone. We evaluated the utility and safety of several nonsurgical tools readily available to most rescue units that could be used for field amputations.
Objective
We sought to evaluate the difficulty and safety of using novel and nontraditional equipment in performing amputations.
Methods
Our willed body program dedicated 24 cadavers for research. The 48 lower extremities were randomly assigned to varying operators and different tools to assess ease and time of amputation and presence of fracture. Several tools were compared: handheld multi-tools, a power saw, 2 types of tree loppers, a serrated knife, and hydraulic cutters. After amputation, the leg was disarticulated, inspected, and radiographed.
Results
Of 48 legs, 21 (43.8%) were amputated using a 24-inch Fiskar anvil tree lopper, 8 (15.7%) using scissor loppers, 4 (8.3%) using a Sawz-All, 2 (4.2%) using a Gerber 06 knife and a Gerber 600 multi-tool saw, 5 (10.4%) using a Leatherman Wave saw, and 8 (16.7%) using the Jaws of Life. The average time required, regardless of instrument, was 13.9 s (range 1.6–149 s). Two tools, the Gerber knife and multi-tool, could not complete the amputation. The scissor lopper was quickest (2.9 ± 0.4 s), significantly faster than any other tool at purely cutting bone (P < .05). Amputation with both loppers and the Jaws of Life had more fractures (29 of 35, 83%) versus none with the Sawz-All and the Leatherman Wave saw (0%; P < .05).
Conclusions
All the tools, save the Gerber knife and saw, were able to complete the amputation through the distal femur by different persons with reasonable ease. The Leatherman Wave saw was the safest and easiest to use non–power tool, whereas the Sawz-All was the fastest and safest power saw.