Guillotine Ankle Amputation Periprocedural Care

Updated: Jun 08, 2021
  • Author: Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS; Chief Editor: Erik D Schraga, MD  more...
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Periprocedural Care


A tourniquet helps improve visualization, especially for ligation of the vascular bundles. If a sterile tourniquet is used, it can be applied within the surgical field and therefore at a lower level. The tourniquet should be applied without exsanguination of the infected foot to prevent proximal spread. It is released prior to wound closure to check for hemostasis.


Patient Preparation


The surgery can be performed with general, spinal, or epidural anesthesia or a regional anesthetic block at the knee, depending on the patient's general health and fitness and his or her condition at the time of surgery. Regional anesthesia is often preferred, mainly to limit the effect on a cardiovascular system compromised by conditions such as septic shock.


The operation is done with the patient in the supine position.