Amputation-General Overview
Definition- An amputation is a surgery to remove a body part. It is removed because of disease or damage.
Reasons for Procedure
An amputation is typically done for one of the following reasons:
Peripheral arterial disease (PAD)
Gangrene
Untreatable pain
Severe soft tissue infection
Severe trauma that can not be repaired
Complications of diabetes
Untreatable bone infection ( osteomyelitis )
Malignant tumor
Congenital deformity (present at birth)
Severe frostbite
Complications of connective tissue diseases, such as:
Lupus
Scleroderma
Possible Complications
If you are planning to have an amputation, your doctor will review a list of possible complications, which may include:
Poor healing at amputation site, resulting in the need for a higher level of amputation
Skin breakdown
Infection
Bleeding
Swelling at surgical site
Phantom limb pain —feeling pain in amputated limb area
Phantom sensation—feeling that amputated limb is still there
Blood clots
Complications of anesthesia
Some factors that may increase the risk of complications include:
Peripheral vascular disease
Diabetes
Infection
Prolonged immobility
Heart disease
Smoking or lung disease
Blood clotting disorders
Certain medicines (eg, steroids)
What to Expect
Prior to Procedure
Your amputation may be planned. In this case, your doctor will review with you how it is done and what to expect. An emergency amputation may need to be done. This can happen because of trauma or life-threatening infection. In this case, you may not have this preparation.
Depending on the injury and location, your doctor may do some of the following before your surgery:
X-rays —a test that uses radiation to take a picture of structures inside the body, especially bones
CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
Bone scan to check for infection
Tissue cultures
Blood tests
Heart evaluation
Preoperative antibiotics
Tests to evaluate blood flow in the part of the body that is being amputated
Leading up to your surgery:
Arrange for a ride home from the hospital.
Arrange for help at home after your surgery.
Follow instructions for eating before surgery—usually nothing after midnight.
You may be asked to use an antibacterial soap the morning of your surgery.
Description of Procedure
An incision will be made into the skin of the affected limb or limb part. If needed, the muscles will also be cut. Blood vessels will be tied off or sealed to prevent bleeding. The bone will then be cut through. The diseased or damaged body part will be removed.
Muscle will be pulled over the bone. It will be sutured in place there. The remaining skin will be pulled over the muscle. The skin will be sewn to form a stump. A sterile dressing will be placed over the incision.
If severe infection is involved, the incision may be left open to heal.
How Long Will It Take?
This procedure can take 20 minutes to several hours. The length will depend on the type of amputation being done.
How Much Will It Hurt?
During the surgery, anesthesia will block any pain. After surgery, you will feel pain as you begin to heal. Your doctor will give a medicine to help manage pain. You may feel phantom pain, which is a feeling of pain in the amputated portion of the limb that is no longer present. If you do, tell your doctor so it can be treated.
Average Hospital Stay
Your hospital stay will depend on the type of amputation you had. Typically:
Foot or toe amputation: 2-7 days
Leg amputation: 2 days to 2 weeks
Upper extremity: 7-12 days
Finger amputation: 0-1 day
Your doctor may choose to keep you longer if complications arise.
Post-procedure Care
At the Hospital
After surgery, you can expect some of the following:
The area involved will be elevated. This will decrease swelling.
Your limb will be dressed in bulky dressing, elastic bandage, or cast.
You will be encouraged to get up and walk as soon as possible.
Physical therapy will begin within a day or two of surgery. It will focus on improving strength and mobility.
You may wear a cast or special shoe for toe/foot amputations.
You may be given certain medicines. This may include antibiotics or blood thinners.
You will be fitted with a prosthesis as soon as your wound has healed.
At Home
Stitches will be removed within a few weeks of surgery. When you return home, do the following to help ensure a smooth recovery:
If you smoke, quit . Smoking can interfere with healing.
Follow the instructions for keeping your incision clean .
Follow instructions on how to care for your prosthesis.
Counseling may be recommended for the emotional trauma of an amputation.
Attend follow up appointments with your doctor. They will make sure you are healing well.
Check with your doctor about which medicines to take at home.
Also, ask your doctor about when it is safe to shower, bathe, or soak in water.
** Call Your Doctor **
After you leave the hospital, call your doctor if any of the following occurs:
Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision sites
Increasing or excessive pain
Cough, shortness of breath, or chest pain
Severe nausea and vomiting
In case of an emergency, call for medical help right away.