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[RavingManiac]

Basically, when a body part is sufficiently damaged by, say, being smashed into a bloody pulp of flesh and bone fragments by a mace, it becomes a better idea to amputate the part than just leave it there to become infected. In real life, this is the usual way that people lose limbs, as having a limb completely removed in battle almost always results in death from blood loss (this is also the reason why you don't see many amputees dwarves in-game).

By having your dwarf doctors cut off mangled body parts, stemming the bleeding with bandages, the patient loses limb, but not life. This means more amputee dwarves wandering around your fortress, and more badass one-armed/one-legged champions.

[Zonk]

It's a good idea.
So good Toady already thought of it 
(from the devlog)
09/05/2009: They excise rotten tissue from wounds now, and they'll amputate limbs that are too rotted to save. Fortunately, I remembered to make them check that they aren't amputating important bits like the head or lower body (although if the head or lower body is actually that rotten, the critter probably would have died already just from raw body damage). Since I had to put infections and systemic problems off, the rotting tissu isn't indirectly harmful like it should be, so for now we can consider it part of odor prevention or something. Though rotting wounds don't smell either. I guess we can just consider it valuable practice for budding surgeons.

[RavingManiac]

Ah, but Toady refers to rotted tissue, meaning tissue that has gone untreated for too long. This suggestions refers to body parts that are mangled beyond repair, but nevertheless fresh.

[Neonivek]

What mangles arms to that extent?

The last thing I remember doing something like that was a fish grinder that basically dusted all the bones in her leg and drained them of vital fluids.

Though it could also be according to the physician. Poor physicians could resort to amputations more often.

[Julius Clonkus]

I think one should be able to choose whether or not to put their dwarves through the long healing process. If you don't want the long healing time, you could have it cut off, which could result in a more quickly healing dwarf, but if the dwarf could handle the pain, he'd get a bad thought. Opposite for wussdwarves with no bigger amount of toughness.
"Urist McBadass was forced to have a limb amputated recently."
"Urist McWuss was forced to endure severe pain recently."

If the limb was mangled beyond healing, it'd be cut off no matter what one says.

[Grendus]

I think one should be able to choose whether or not to put their dwarves through the long healing process. If you don't want the long healing time, you could have it cut off, which could result in a more quickly healing dwarf, but if the dwarf could handle the pain, he'd get a bad thought. Opposite for wussdwarves with no bigger amount of toughness.
"Urist McBadass was forced to have a limb amputated recently."
"Urist McWuss was forced to endure severe pain recently."

If the limb was mangled beyond healing, it'd be cut off no matter what one says.

That's... sickening. Seriously, the only time a saveable limb is amputated is when time is extremely valuable (such as the limb is trapped and you have to escape, or if the time saved by not reconstructing one limb can be used to save another patient's life). You don't amputate an arm out of "convenience", only out of necessity.

That said, I think any limb that is mangled beyond saving will rot and be amputated anyways. It's just delaying the inevitable currently.

[Julius Clonkus]

That's... sickening.

Yeah, it's cruel. But I don't know, with people breaking every bone in some innoncent creature, training up Wrestling by mutilating zombies, cooking the occasional Siege (and elven caravan) in magma and slaughtering kittens to the hundreds, it seemed not that awful on the first glance.

[Footkerchief]

This was discussed in some detail in the List thread.  It doesn't sound like it's been entirely implemented for the next release, but he's cognizant of the need.

Hey Toady, can you give us a list of what kinds of surgeries will be done? I'm just not sure how deeply you programmed it as far as that goes. I mean like, will we see them performing open heart surgery, fixing internal organs, stopping internal bleeding....

Right now surgeons work to stop bleeding (including bleeding that comes up from their oopsies), repair compound fractures and remove rotting tissues, including amputations.  If I remember, most internal surgeries were out of the range of what can practically be attempted, but to some extent I might have just run out of time since the medical notes prepared by SirHoneyBadger were super thorough and covered way more than I could for this release.

Is rotting tissue the only reason they amputate? They should also do it in the case of extremely painful injuries or breaks that won't heal, or when there's a lot of damage to the limb's circulatory structure.

Bad compound/etc. fractures were supposed to lead to amputations but I haven't gotten a chance yet.  That's something that's sort of hanging right now and may or may not happen, but yeah, lots of reasons to amputate.  An I was Bitten guy just lost his leg to a hungry tiger, who only got halfway through the leg itself before being hit by a guy with a pickaxe.  Very proper.  So yeah, not being able to save the limb should happen more often.

Are we going to see societies that use amputation as punishment? It'd be funny to add "Getting a hand chopped off" to punish_severe for things like stealing. You could also have surgeons acting as torturers in societies where that sort of thing wasn't looked down upon. I can see a goblin putting out an elf's eye in order to convince him to give up the location of the druid's hideout, or hobbling dwarf prisoners to keep them from running away.

He he he, yeah, it's a very reasonable thing.  The more the better really.  Right now they just torture people to death or abuse their corpses lots of ways in world gen, and that should become visible and be extended to the not-killing-them realm.

[ArkDelgato]

"Urist McBadass was forced to have a limb amputated recently."
"Urist McWuss was forced to endure severe pain recently."

Doctor House is no wuss.
It keeps him on his game.