Above knee amputation

1.Position the patient supine with the leg wrapped in drape/crepe.
2.Make a fish-mouth incision at the level of intended amputation (supracondylar, diaphyseal or sub-trochanteric) usually a hands-breadth or 10cm above the upper border of patella, ligating the long saphenous vein medially.
3.Divide through the anterior compartment and contained quadriceps, sartorius and subsartorial canal with ligation of femoral vessels and saphenous nerve. Deep to the quadriceps and on adductor magnus, adjacent to the femur ligate the profunda femoris vessels. Bevel the muscle down to the femur proximally.
4.Divide through the posterior compartment and ligate the sciatic nerve.
5.Transect the femur with a Gigli saw and bevel the edges round with a rasp.
6.Place an epineural catheter near the stump of the sciatic nerve and infiltrate bupivacaine.
7.Close in layers using 3/0 vicryl/monocryl.