UNTIL the past few years major amputation in obliterative arterial disease has been associated with a distressingly high mortality. As recently as a decade ago, published figures ranged from 13 to as high as 80%.1 In 1940, Veal2 remarked that the "mortality rate for amputation of a lower limb for vascular gangrene has remained excessively high, although it was one of the earliest major operations to be performed. Even the introduction of aseptic surgical technique and safe anesthetic agents has failed to reduce this rate in proportion to most other standard operations."
During this period most of the major amputations in the lower extremity were carried out through the thigh, and, to be sure, the same policy is generally followed at the present time. There have been, of course, exceptional surgeons, such as Maes,3 who some years ago recommended closed amputations below the knee. The Council on