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There have been a lot of questions about zombie bites on this site. From making it lethal to allowing for an amputation cure. But we have not discussed the primary issue of this line of questioning is its feasibility.

Even assuming that a quick amputation can prevent the zombie infection, there are a plethora of problems that come from even regular amputation; blood infections, mobility issues and anemia to name a few. And that's under modern circumstances, where these problems have real solutions and are unlikely to even appear.

In the end times, the chances of these problems occurring increases and their solutions become much more difficult to deal with. Additionally, new problems arise such as bleeding out or being unable to do post-apocalypse related tasks. For example, someone missing a hand would be unable to open cans or climb ladders quickly, while someone missing a leg would be unable to run.

Considering these problems that exist even with a guarantee of removing infection, would an amputation in the apocalypse be feasible?

To avoid the obvious overbroadness, I will narrow down the situation below. While this may over narrow the answers, the basic point or principle of the answer should apply to over situations.

We are to assume the bite victim is a young man (21-30) and belongs to a small group. They will have some first aid supplies such as hydrogen peroxide and gauze, but lack things like bone-saws or heavy duty antibiotics. The amputation is, of course, rushed and done with an ax. To avoid being overly broad, let's assume that the amputation is indeed a success and the zombie virus is of little concern.

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    $\begingroup$ There is en.wikipedia.org/wiki/Aron_Ralston $\endgroup$ – Flummox Mar 30 '17 at 9:38
  • $\begingroup$ Feasible in terms of what? Viability as a procedure? Chance of continuing survival? Chance of avoiding further contamination? $\endgroup$ – Frostfyre Mar 30 '17 at 12:02
  • $\begingroup$ Are you saying that that the amputation is a success in that there is no zombie infection and that he survived the procedure? $\endgroup$ – apaul Mar 30 '17 at 15:09
  • $\begingroup$ @Frostfyre chance of avoiding further complication $\endgroup$ – TrEs-2b Mar 30 '17 at 16:42
  • $\begingroup$ @apaul34208 we are to assume for simplicity's sake that yes, the amputation succeeded $\endgroup$ – TrEs-2b Mar 30 '17 at 16:43
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Allowing for the premise I still have my doubts about field amputation without a trained surgeon.

The most relivant statistics I could find come from the American Civil war, where field amputation was a common treatment for wounds to the extremities.

Primary amputation mortality rate: 28%. Secondary amputation mortality rate: 52%

Primary being death in surgery and Secondary being death from subsequent infection. It's also worth noting that those figures get much worse the closer you get to the body. Upper leg amputation mortality was 83%

There are a few differences worth noting...
Civil war surgeons weren't familiar with the concept of sterile surgery, so I suppose your people get a very small bonus there. Also contrary to popular depiction most Civil War amputees did have the benefit of anesthesia, which would be a huge deficit for your​ people. Also keep in mind that while Civil War surgery was crude the surgeons got a lot of practice, at least they had done it before... I very seriously doubt that someone who had never even witnessed an amputation could successfully pull it off.

So... In short your chances of surviving a post apocalyptic amputation are slim. I would put the mortality figure somewhere around 75-85% for a lower limb. Probably 90-95% closer to the body.

Keep in mind that there is a world of difference between slapping on a tourniquet, hacking off a limb, and getting the person to a hospital vs. a field amputation and hoping for the best...

It seems I may not have expounded on the point well enough... The difference is dealing with the nitty gritty.

In a field amputation you anesthetize the poor guy, tie off the limb with a tourniquet, cut the skin being sure to leave a flap, slice through the surrounding muscle and tissue as quickly and cleanly as possible, tie off the spurting arteries with a piece of thread, scrape the bone smooth to remove sharp edges, suture the stump using the remaining flap of skin being sure to leave a port for the wound to "seep", and finally wrap the remaining limb in a cast of sorts, and further medicate with powerful painkillers (heroin) for several days while the poor guy writhes in agony.

Do you really think a layman can do that... Before the guy bleeds out... With a struggling, screaming patient...Without anesthesia... ?

Source: https://ehistory.osu.edu/exhibitions/cwsurgeon/cwsurgeon/amputations

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    $\begingroup$ This was an eye opener. I guess the movies (or even books) never did it justice. Even the more clever ones I've read $\endgroup$ – Yuriy S May 31 '17 at 11:25
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In First Aid, there's a set procedure that gets followed:

  • Danger - Ensure that your patient and surrounding people are safe from any immediate danger before you do anything else
  • Response - Is your patient able to respond to instruction
  • Airway
  • Breathing
  • Circulation

In terms of a zombie attack, you're hampered by the first of these procedures. you're not likely to be able to have your casualty moved to a place of safety before they either bleed out and die from shock or the infection travels too far though their body.

Pertinent fact #1 - It takes roughly one minute for infected blood to travel around the body
Pertinent fact #2 - Robert Lister (fastest knife in the West End) could amputate a leg in two and a half minutes

Basically, if one of your party gets severely chomped upon, just leave him for the safety of the larger collective - he'd do the same for you.

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    $\begingroup$ This question assumes the limb has been removed and asks about the feasibility of surviving the after effects. $\endgroup$ – TrEs-2b Mar 30 '17 at 9:28
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    $\begingroup$ And I'm questioning whether that's feasible in itself... If infection time is counted from the first bite, could you extricate the victim from the zombie in time to amputate and cauterize the limb before terminal infection sets in? $\endgroup$ – Snow Mar 30 '17 at 9:33
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    $\begingroup$ Tourniquet only reduces blood flow. Can't cut it. So it depends on the amount of virus needed for infection. But minutes, not hours. At best minutes. $\endgroup$ – Mołot Mar 30 '17 at 9:39
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    $\begingroup$ @Flummox - Tourniquets don't help with snake bites, so it won't help with a zombie infection. $\endgroup$ – Snow Mar 30 '17 at 9:41
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    $\begingroup$ It's just like talking space travel and saying that gravity is not the factor... Everything starts to depend on the amount and application of handwavium. $\endgroup$ – Mołot Mar 30 '17 at 11:09
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Feasibility depends on the situation. If you are on the run, no, use your fallen comrade as zombie bait. Sorry Able, but your sacrifice will ensure our survival (for a short while).

But if things are a bit more stable, you have a fort, island or secluded hide-away, yea, you can do this.

Setup: We have a save place, with 100 or so people. Labour is split up a bit, each puling their worth. And so our group of 7 lad's is going out for a patrol, looking for useful items. Let's call them; Baker, Charlie, Dog, Easy, Fox, George and How. Baker is team leader, Charlie is backup leader. Each lad knows how to hold down a dude. Probably need at least 3 of them. Dog and Easy know how to butcher. Fox and George know how to deal with heavy bleeding. All carry tourniquets. They have been trained by Uncle, who has some nasty memories from Ganners.

Encounter: Our little expedition runs into Zed. Zed is not alone, meet Zedd and Zeddy. Our lead dude, George, was a bit unlucky, and so has his left foot bitten. Dude, not cool! Let's go into the drill from Uncle: Care Under Fire.

  1. Take care of your own safety.
  2. Let George himself put on a tourniquet. The limb is toast, hopefully he isn't.

  3. Zed, Zedd and Zeddy are taken care off by the other members of our group.

  4. Charlie secures the area.

  5. Baker, How and Easy hold down George.

  6. Dog cuts off the infected limb. If possible at a joint.

  7. Fox cleans the wound with hydrogen peroxide and then stops the bleeding.

  8. George is in a bad way, but we need to get him back to base. Make a stretcher, carry with 4 man, 2 man guard. MOVE!!!

Back at Base: So, George made it, thanks to the fast work of his mates. He will need weeks, if not months, revalidation. I hope you have someone who can make prostheses. For George's sake I hope he is good with his hands and brains, for speed and strength are no longer there for him. As long as George doesn't have to run to save his live, he is good. There are a lot of jobs you still can do without legs. Heck, you can even shoot in a sitting position from a nice tower.

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First consider two factors seen in many zombie fiction. Some movies have a much faster rate of infection, but let's look at the gold standard.

  1. A zombie bite leads to an infection, fever, then death as a result of the illness, and reanimation as a result of the death.

  2. Anyone who dies regardless of the cause, might already be infected and therefore if they die, reanimation results.

So what does this tell us about a zombie bite? It tells us that the goal is to quicken the pace of death in order to create a new zombie more quickly than regular death.

What this might mean, depending on how your world works, is that a zombie bite might feature two things--a gangrene-type necrosis/infection which causes death because of the body's dramatic immune response to it, and a viral load which ensures that reanimation results, regardless of whether the subject was previously infected.

In this case, cutting off a hand bitten by a zombie might be enough to stop the immune response if caught in time, but the victim may still die of anything from blood loss to a regular infection as a result of cutting off their hand in less than sterile conditions. Regardless of why they die, after they are bitten, and die, they will reanimate.

Now, given the available tech and level of expertise, I would say that in this situation, your young man is going to die anyway. Because a real amputation involves tourniquets, knowing where to find the major blood vessels and tying them off to prevent them bleeding out. In the Civil War, the death rate was something like 24-30% for any given amputation, but despite the low level of tech, they would have a bone saw, and the many, many amputations turned some of the doctors into experts on how to do it. Death mainly resulted because of infection, since the conditions were not great. A good amputation job means that you actually dissect a bit, and you cut extra skin in order to cover the stump.

Just chopping something off with an axe--that's going to actually result in a quick death. For a non-expert without any real tools, immediate cauterization is really your only hope, and that's only if folks have figured out the tourniquet bit.

As to after-care, that will be a little more complex, and post-amputation, most people are not up to running about.

For survivability afterwards in post-apocalyptia if the amputation is a success, this would depend on the limb, handedness and a host of other factors--and seems to be enough for a whole other question.

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You have only two options:

  1. Amputation of the limb
  2. No amputation and killing the infected

If you want to preserve as much as possible the men count in your settlement, amputation is viable, as long as you make clear priority definition (e.g. will you risk a man to save an amputee on an emergency?)

To speed up the amputation you can use cauterization on the wound.

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I'd say not.

First, the survival rate is going to be low anyway.

But that's not the problem. The zombies are the problem. By definition, your group is in a zombie infested area, and sufficiently vulnerable that members of your group can get bitten. So even if the amputation is a success, your group will be immobile for a while whilst you tidy up the amputation, your amputee will almost certainty be making a lot of noise, and is going to be a liability for some time afterwards. If it's a leg amputation, you will be slowed to a crawl; but even arm amputations will leave the amputee in a very poor state for a while.

So.. you are in a vulnerable position, you'd just made enough noise to attract every zombie for miles around, and you can't move your group at any kind of speed. I think the zombies will be eating well tonight..

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I don't like a zombie infection to be a viral thing. I have come up with a zombie outbreak unrelated to a virus and very specific in terms of effectivness, but I wouldn't share it. However, the mechanics of it can be applied to a zombie virus.

The virus is effective in great concentrations. It's a failed synthesized virus, originally meant to regenerate tissue. Hence, it focuses around the bite first, attempting to fix it, but fails, and proceeds to spread elsewhere. Removing the location of the bite stops the infection form spreading.

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  • $\begingroup$ Hi, ThomasNicholson, welcome to Worldbuilding, your answer seems to suggest amputation of the site of infection will work. However, your answer can be improved by providing more facts, information and reasoning why this will work. Your paragraph one can be amputated without affecting the quality of this answer. Adjusting to WB can take time. hang in there it's worthwhile. Have fun! $\endgroup$ – a4android Mar 31 '17 at 1:03

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