The evolution of lower limb amputation through the ages. Historical note.

The aim of this study was to highlight the important stages of the evolution of limb amputation through the ages through the search of the relevant international literature. Limb amputation is one of the most serious surgical operations, which is associated with high mortality and morbidity. Evidence regarding the execution of limb amputation can be found back in Neolithic times. The most important steps in the evolution of the technique of limb amputation were made in the 16th, 17th, and 18th centuries when A. Pare' introduced the vessel ligation and the French barber surgeon Morell introduced the use of a tourniquet to reduce the bleeding. During the same period, from the 'one-stage circular cut' the technique evolved to either 'three-stage circular cut' or to 'flap amputation', single or double. Limb amputation represents one of the oldest and most serious surgical operations. Its evolution parallels the maturation process of surgery, with the major developments in the technique to have been made from the 16th to the 18th century. In the beginning of the 21st century, limb amputation appears to be a safe operation ending up with a functional stump.