You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is 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? and explain in detail?
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 (TcPO2)values > 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 patient's nutritional status before considering amputation. Ankle-brachial Index (ABI) > 0.9 indicates absence of vascular injury and values < 0.45 indicate severe injury.