<prompt> A 37 yr old male brought to emergency room late after road traffic accident . On examination the capillary refilling time is delayed in the left lower limb . All are indications for amputation in this patient, except?Transcutaneous Oxygen Tension - 40mmHgSevere Peripheral Vascular diseaseAnkle-Brachial Index 0.45Fulminant Gas Gangrene  <response>: Causes of Amputations three Ds: 1 Dead, 2 Dangerous 3 Damned nuisance. Dead or dying Peripheral vascular disease accounts for almost 90 of all amputations. Other causes of limb death are Severe trauma, burns and frostbite. Dangerous disorders are malignant tumours, potentially lethal sepsis Gas Gangrene and crush injury. Damned nuisance: In some cases retaining the limb may be worse than having no limb at all. This may be because of: 1 pain; 2 gross malformation; 3 recurrent sepsis or 4 severe loss of function. Transcutaneous Oxygen Tension TcPO2values 40 mmHg are indicative of healing whereas values 20 mmHg are indicative of non-healing and impending limb loss. For values between20- 40 mmHg, the clinician needs to consider co-morbidities like vascular disease, diabetes etc and the patients nutritional status before considering amputation. Ankle-brachial Index ABI 0.9 indicates absence of vascular injury and values 0.45 indicate severe injury. 