The arteries are the blood supply vessels of the body. After the arteries emanate from the heart, they send out large arteries to the extremities, head and vital organs. In the arm emits the axillary artery, in the upper arm is the brachial artery, below the elbow joint is divided into two, the radial artery and ulnar artery. In the movie, the shot area is near the elbow joint, and the only brachial artery is damaged, and you can see that there is still a pulsating blood spray locally after wrapping the bandage. If persistent bleeding can lead to death by hemorrhagic shock, it is conceivable that a suicide by slitting the wrist can lead to death by blood loss by simply damaging the radial artery, which is much thinner than the brachial artery. And bandage strangulation compression can reduce local bleeding, but also lead to the following parts of the elbow severe ischemia, and once the limb has no blood supply, just like the crop without water and fertilizer, will lead to depletion necrosis. Some people may ask, the arterial blood vessel is pierced and then connected can not be? Is it that the medical conditions at that time could not connect the blood vessels? This friend knows medical knowledge and knows that modern medicine can “connect the blood vessel”, the technical term is called “vascular anastomosis”, which is to sew up the broken blood vessel, or if the damage is too serious, this part of the blood vessel can be removed and anastomosed with an autologous vein or artificial blood vessel. This is called a “vascular anastomosis. There is a time window, or a time limit, after which vascular surgery cannot save an ischemic or necrotic limb. To use an analogy, it is similar to a person’s tolerance to oxygen deprivation, which can be completely compensated for in just a few seconds and has no effect on the body. Because the body has oxygen reserves. If more than 30 seconds, the body will be unbearable, and even fainting. Any longer and the person will suffocate and die. There is a limit to the tolerance time of each tissue of the limb for acute ischemia, usually 4-6 hours for nerve tissue, 6-8 hours for muscle and 8-10 hours for skin, beyond which irreversible damage to the body tissue will occur. Therefore, the golden time for acute limb ischemia treatment should be within 12 hours after the onset of the disease. Tissue ischemic necrosis will cause serious metabolic disorders, manifested as hyperkalemia, myoglobinuria and metabolic acidosis, eventually leading to life-threatening renal failure, and the emergence of limb necrosis will require amputation to preserve life. Which department does amputation surgery? People have the impression that amputation is to saw the bones, so they take it for granted that orthopedics should do this surgery. It is true that orthopedic surgeons are responsible for amputations for traumatic injuries such as car accidents, bone tumors and other diseases. However, at present, the most amputations are done by vascular surgeons. During the war years, gunshot wounds were a common cause of amputation. In peacetime, the majority of amputations are performed due to lower extremity ischemia (peripheral arterial disease, embolism) and diabetes. Trauma is the 2nd leading cause, such as car accident trauma, and the third is due to malignancy. The presence of peripheral arterial disease alone or the combination of this disease with diabetes accounted for more than half of all causes of amputation. The Task Force of the Transatlantic Collaboration Consensus (TASC) reports that peripheral artery disease causes 12-50 major amputations per 100,000 people per year. Over the next 15 years, an aging population will increase that value by 50%. Why is a vascular surgeon performing amputations? Because for amputation caused by ischemia, the wound may not heal if the amputation is small, and the prosthetic movement may be affected if the amputation is large. How to determine the scope of amputation needed and whether to perform embolization or bypass surgery at the same time during the surgery depends entirely on the vascular surgeon to determine, so the vascular-related amputation is done by the vascular surgeon.