GUILLOTINE AMPUTATION

R.S. is a 68 year old black female with Diabetes Mellitus, and End Stage Renal Disease (ESRD) on kidney dialysis, who developed gangrene in the middle toe first, and then in the second toe after a minor bump. The gangrene started spreading up into her foot, and her foot became infected.

She became very toxic, with high fevers and highly elevated white blood cell count. Emergency guillotine amputation was required, in order to get the dead, infected tissue out of her system. Revision of the stump and secondary closure would come the following week.

Notice how the gangrene is spreading into the bottom of the ball of the foot.

All 5 metatarsal bones are exposed in these pictures.

Her circulation was so poor that she lost less than one ounce of blood during the operation, and no tourniquet was used.