Amputations

Overview of Amputations

Amputation is the removal of a limb (arm or leg) or part of an extremity (foot, toe, hand or finger/s) when an alternate treatment is not available or has failed. Underlying issues creating a need for an amputation include:

• Extensive infection
• Lack of blood supply
• Significant trauma
• Frostbite
• Severe burns
• Wounds
• Presence of a tumor

Almost 300,000 amputations are performed in the US yearly. The most common underlying condition predisposing to amputation is diabetes.

Preparation for an amputation

• Typically these are elective cases so there is time to prepare
• Optimize nutrition
• Control any extremity swelling
• Mentally prepare- artificial limbs have improved significantly to allow an amputee to maintain their ability to maintain an independent life

Amputation surgery

• It take place in the operating room.  
• In most circumstances, you will be put to sleep under general or spinal anesthesia.  
• The affected extremity will be prepped with an antiseptic solution and sterilely draped. 
• An incision will be made that allows for sufficient healthy tissue to cover and protect the amputation stump, then the limb or extremity will be removed, and the stump will be closed. 
• In cases of extensive infections, the stump may be closed during a second procedure to allow time for the infection to drain
• After an appropriate healing interval (3-6 weeks), you will be custom fitted with a prosthesis to begin the process of regaining your independence.

Risks

• Bleeding and infection are possible following any surgical procedure.  Your surgical team will stop any bleeding that occurs in the operating room, and a drain may remain after surgery to monitor post-operative bleeding.  To prevent infection, preoperative antibiotics are administered and skin will be cleansed with an antiseptic solution.  Still, infections sometimes occur and require treatment.
• Poor would healing or wound breakdown may occur, particularly if your surgery was due to infection or poor blood flow.  Your surgical team will meticulously check your incision during your hospital stay to monitor healing and watch for signs of infection.
• Blood clots in the legs can develop due to lack of mobility after surgery.  Low-dose blood thinners are often used to prevent clot formation.
• Phantom pain, a sensation that the limb is still there, sometimes occurs.  It can often be treated with medication or therapy.
• Other medical conditions, including coronary artery disease, heart disease and diabetes can increase your risk for post-operative complications.

Recovery

• Anticipate 3-5 days in the hospital.
• You will meet with, physical medicine doctors and physical therapists to learn the exercises necessary to regain your independent life.
• It may be necessary to transition to home through a short stay in a skilled nursing unit that focuses on rehabilitation.
• Once your surgeon is comfortable the wound has totally healed- 3-4 weeks- you will be fitted with your prosthesis.