How can leg amputation be done and how would the amputee recover in a post-apocalyptic world? (50 years after our current time)

Question

I am writing a story where my main character and her friend gets transported to a post-apocalyptic future that takes place 50 years after the time period they lived in. She eventually gets her leg amputated when they were attacked and had to undergo recovery in an abandoned hospital with the friend who is an experienced medic.

The abandoned hospital that they take refuge in has a secret safe (still unopened) which contains medicines that are still usable. Since the friend is a medic who had worked in the exact same hospital, she knows how to find and open the safe.

Since it is a post-apocalyptic world, there are dangers around every corner. These two characters will have to fend off raiders and other invaders that threaten their lives. Since my main character is an amputee, she will have difficulty recovering at the usual rate as our real world since she can't stay in one place for too long. (I was thinking that they leave the hospital 5 days later after the surgery and she will be using crutches to help her walk)

So my questions are:

1. Will the medical supplies not in the safe still be usable? (Either they are lying around or kept in plastic containers)

2. Can leg amputation still be done by a single medic using the available medical supplies they salvage from the safe?

3. How will you recommend my mc heal her amputation wound while trying to survive in the abandoned hospital that could have raiders coming in to raid stuff and most likely kill her?

Answer 1

Will the medical supplies [...] still be usable?

After fifty years, I'd be slightly dubious. Plastic and rubber perishes, metal rusts, paper and fabric rot. Chemicals will denature via a whole range of pathways. Equipment is unlikely to be sterile (but some of it you'll be able to re-sterilise easily enough) and pharmaceuticals are likely to be either useless or perhaps even toxic.

If fewer than fifty years passed between the abandoning of the hospital then you may well be in luck. Lots of pharmaceuticals carry on being reasonably effective even years past their expiry dates. Ten years might be pushing the boundaries here, but under ten years seems like a bit of a short period of time to produce an authentically post-apocalyptic environment.

There will of course be some kinds of useful tools which are difficult to improvise well. The patient is likely to be happier in a (former) medical environment than if you took them to a former abbatoir or butcher's shop, even though the important tools are likely to be quite similar in all those case...

Can leg amputation still be done by a single medic using the available medical supplies they salvage from the safe?

If you look at how amputations used to be done, you can see that with a bit of practise and some suitable ironmongery you can have someone's leg off pretty promptly and perhaps without too much mess.

Keeping everything clean and sterile will be tricky, and the chances of you finding any kind of useable antibiotics are slim. People survived amputations back in the day, before anaesthetics and antibiotics, so clearly it is possible with a bit of luck, and your medic may be better placed to ensure success than surgeons from a few hundred years ago.

How will you recommend my mc heal her amputation wound while trying to survive in the abandoned hospital that could have raiders coming in to raid stuff and most likely kill her?

You're the author; you write the story ;-)

Answer 2

As noted by @StarfishPrime, amputation isn't a high tech procedure at its core. Amputation as a procedure (for shattered bones, most commonly) goes back to Egyptian times, and people did survive it (leading causes of death during/after amputation were blood loss and infection, with shock a co-morbidity). Blood loss and shock are minimized by operating as quickly as practical; the mark of a competent battlefield surgeon during the 18th and 19th centuries was how rapidly he could amputate a leg -- I recall reading of surgeons who could do the job in much less than ten minutes.

Use of cautery after the surgery both halted blood loss, and (slightly) reduced the chance of infection, and if the surgeon is even aware of the germ theory, sterilizing the tools with heat is an available technique throughout antiquity (boiling water or a careful pass through a flame -- don't want to heat the metal too much, else you destroy the temper).

Medications more complex than simple chemical disinfectants are unlikely to still be effective after fifty years, unless stored in a working deep freeze (liquid nitrogen would be better, but is still less likely). Yes, this includes the contents of the unopened safe, with one possible exception: if that safe or the packaging within is airtight (and ideally has antioxidant packets, like you'll find in bottles of aspirin) inside, it might extend the life of relatively simple products -- pain relievers, some antibiotics, for example -- by enough to be still effective at increased dosage after that much time.

Modern medical practice has surgical patients walking (in a limited way) literally as soon as they're fully awake from the anesthetic (I was out of the bed less than an hour after waking up from a triple bypass -- more like twenty minutes after passing a basic lucidity screen, "Where are you? Who's president?" type questions). The movement and its effects on the cardiovascular system are now considered better than the benefits of prolonged rest with its then-lengthy period of recovering mobility. That to say, your amputee should be up on crutches literally as soon as she can stay fully alert in an upright position (though care and a "buddy" to watch for balance problems would be highly recommended for at least a couple weeks).

Answer 3

I'm going to address mostly point 3 as I think preforming an amputation, while dangerous, isn't that difficult considering successful amputations have been preformed since antiquity with some evidence of amputations going back to 4000 BC.

How mobile/capable your amputee is depends in a large part on where on the leg the amputation is preformed. Generally, the closer to the hip, the less mobile they will be afterwards. Specifically, in a post-apocalypse scenario, someone who's amputated above the knee will require a wheelchair or two crutches forever. If it's below the knee, then there's more of a chance at a somewhat-mobile lifestyle. Mechanical prosthesis or an "off-the-shelf" prosthetic that you might find in a hospital could be used.

Other ideas:

• The Medic friend straps the injured party to their back and carries them around everywhere (requires a light friend or a buff medic)
• The characters requisition some physiotherapy equipment to help the injured party walk. Depending on how far in the future this apocalypse takes place, it wouldn't be entirely unreasonable to find an exo-skeleton walk-assist device.
• Current and "next-gen" artificial limb technology is capable of being directly mind-controlled and even providing rudimentary sensory feedback. While it's unlikely that the hospital has some artificial legs lying about (as they will most likely be made to order), I expect that complete and seamless robotic limb replacement will be possible in 50 years. Still, even with a cyborg limb physical therapy would still be required to learn to walk
• The crippled party overtakes a role that doesn't require moving. For example they could be a sniper positioned in an overwatch position or they could take on a "control room" role where they watch security cameras, trigger traps by pulling on strings, and coordinate the people who can walk.