Amputation and Skin Grafts

Two of the most gruesome and popular procedures during the Civil War were amputations and skin grafts. A combination of a lack of proper resources and a lack of a sterile environment meant that these two very invasive procedures often had fatal results.

Often, whenever a soldier suffered any sort of battle wound affecting his arm or leg, the common response was to simply cut it off, because cutting it off was easier than dealing with whatever infection or injury the limb had aquired. This meant that amputation was one of the most popular procedures, performed about 60,000 times by battlefield doctors during the Civil War (7). Colloquialized as "tent amputation," many of these amputations had to be performed outside (or in a tent in more fortunate circumstances) due to a lack of space in the actual hospital (8). A picture of this outdoor procedure can be found on the main "Surgery" page. Because amputation was such a common procedure, it was often performed very hastily and carelessly, and it often took less than 15 minutes. In fact, sometimes the saw wasn't even cleaned in between each procedure, so as to save time. Amputations were so brutal that out of around 30,000 Union amputations performed, about 7,500 killed the patient (9). After the amputation was completed, many patients were given early prosthetics to use. Although very basic and limiting in the patient's mobility, these prosthetics actually did help the patient pretty substantially (10). Sometimes, however, doctors were actually able to salvage the limb that would otherwise be amputated. Although this is common practice today, this procedure is one that was relatively rare and difficult during the 19th century. Although it was only available for patients with flesh wounds and minor bone injuries, this was a far better option than amputation. In this procedure, the wound was first cleaned of bone fragments (and other materials which may have been lodged in the wound) and then bandaged up to heal. The main issue with this procedure was the bandaging. In most cases, the bandaging was simply not enough to keep out infection, and often the limb became so infected that amputation actually became necessary (11).

An innovative procedure during this time was skin grafting. Today, this is a common procedure, but during the Civil War era, it was revolutionary. The operation has greatly progressed since 1865, and we are now able to keep skin alive even if it is detached from the body. During the Civil War, when a skin graft was performed, the doctor would cut skin from someplace on the neck or shoulder, and actually pull the skin up to the affected area on the face. Once the skin had taken to that area, the doctors would cut the skin to disconnect the face from the shoulder or neck. While the operation was often functionally successful, it often made the patient look strange directly after the procedure (12).