How do amputations or major operations occur without insane blood loss/death?

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How do amputations or major operations occur without insane blood loss/death?

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Tourniquet.

Like in a bombing or major incident you take a tie or shoe lace and tie it above the bleed VERY tight, so tight it stops blood flow to the limb.

There’s a couple of things that are done.

-Initially, a tourniquet if this is a triage situation.

-During surgery, some of the cutting is done with tools that cauterize smaller vessels and that staves off bleeding.

-bigger veins/arteries are clamped off.

-Blood transfusion throughout the surgery keeps blood coming in.

I’m sure there’s a lot more that goes into it and more technical answers will be offered, but I think that’s the upshot.

Most surgeries are electrosurgery. No scalpels. Just a cauterising machine. Smells like pork

Yes. A belt is wrapped just above the area going to be amputated when tight enough the blood flow stops in the area about to be cut off. Then after it’s been sawed off I believe the area is fused or cauterized with electricity.

Part of a surgeon’s skill is to recognise larger blood vessels, which are avoided entirely, or tied off if it is part of the procedure/if needed.

Smaller blood vessels are either cauterised or tied off as the surgeon goes along. The surgeon often will not proceed until each new area they cut through is free of bleeding. Before finishing, they also make sure they are no areas of active bleeding. The body will them form new vessels as part of healing.

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These are all very basic principles of surgery precisely because it can be fatal if not followed.

In traumatic amputation, the arteries contract slowing the bleeding. The muscles also spasm and contract slowing it more. It’s how an arm or hand can be ripped off and you don’t bleed out immediately and they can try to re-attach.

As to surgery, see the other posts.

In addition to what others have stated, there’s also tools that work like temporary tourniquets that can be used in planned amputations. These devices are applied on the limb in a manner similar to a blood pressure measuring device and can be inflated mid-surgery to stop blood flow in the limb temporarily and make for a relatively unbloody surgery. These are also commonly used in ACL reconstructiony or knee replacements e.g. I don’t know, however, if they’re also applicable on upper extremities.

Really trying to ELY5. There are several ways to avoid insane blood loss, and many times several are done at once. You can put pressure on the area, or even completely close a blood vessel, so that less (or no) blood comes through, and there’s less bleeding when you cut up. Also, there are tools which burn at the same time they cut, so whatever hole they create is immediately sealed, which means that there’s less bleeding. Even then, there are many cases where people need blood transfusions after the surgery, but fortunately, they’re not as common.

By working meticulously and ligaturing major blood vessels before cutting them, Electrocautery is also used, this method seals smaller vessels when they are cut. Any if you miss one, you quickly put a clamp on it to stop the bleeding.

As a veterinarian, I do not have access to blood bank for my surgeries (pretty much never done ifor surgery n veterinary medicine aside for referral centers). By knowing your anatomy and working metodically you can control the bleeding to a minimal. Most vets don’t even have electrocauthery so just knowledge, and skills,

We don’t use tourniquets for planned amputations (like for unrepaireable fractures or tumors), those would just be used for acute trauma until surgey is done.

With modern surgery and anesthesia, it’s not a race, the goal is to minimize the loss for the patient and give the most optimum condtions for the amputated area to heal properly.

In addition to the torniquet and diathermy posts above, tranexamic acid is also used to control the amount of bleeding in orthopaedic surgery, which has greatly reduced the need for transfusing.

You have to learn human anatomy, not just bones and organs but you have to know where every blood vessel and significant nerve is (you don’t want to cut those either)

Also for the most part opening up a living body like lifting the hood of a car is over, most of it is done through a tube with tiny instruments.

FYI, a decade ago I was waiting for my mom at Madigan hospital when they had set up new million dollar robot controlled surgical machine (da vinci?) and since the doctors were inside the lecture hall I got to play with it, they had set up a demo where you tried to put rubber bands around various silicon shapes.