Decision making in the management of severe limb trauma

THE veterinary surgeon charged with the care of a patient with a severely traumatised limb should never lose sight of the fact that his or her first duty is to save the patient and any thoughts of saving, salvaging or repairing a limb must come second to dealing with any life‐threatening injuries. The fact that a limb can be salvaged does not necessarily mean that it should. Amputation is simple, relatively inexpensive and predictable in its outcome and, following severe limb trauma, can render a patient mobile and painfree within a remarkably short period of time. Amputation should always be considered, especially in smaller, less active or aged patients whose quality of life is not likely to be significantly impaired by the loss of a limb. Amputation also has a place in cases where financial constraints and/or lack of available expertise preclude a more complex approach. In cases which are genuinely beyond repair, the decisionmaking process is simple. However, often the decision to salvage or amputate is complex and heavily influenced by a number of subjective or non‐clinical factors. The aim of this article is to assist the clinician faced with a severely traumatised limb to plan a rational course of action tailored to the individual needs of each patient and client.