Limb Amputation

Amputation

Amputation refers to the removal of a part of the body or a limb

Causes of Amputation
    • Amputation may be necessary due to severe infections resistant to treatment, accidents, congenital or acquired deformities, frostbite, malignant tumors, diabetes, or gangrene caused by bites. However, the most common cause is progressive vascular disease.

      The purpose of amputating a damaged (necrotic or gangrenous) limb is to preserve the remaining healthy parts of the body. Diagnostic tests such as angiography or Doppler ultrasound can help determine the appropriate level of amputation.

      After surgery, the patient remains under medical supervision in the hospital for 3 to 7 days. Elderly individuals or patients with additional health conditions may require a longer stay. The main objectives of this recovery period include:

      1. Pain management
      2. Wound care
      3. Muscle contraction and relaxation exercises
      4. Training on safe bed mobility to prevent complications
      5. Training on walking with crutches and assistive devices
      6. Learning to manage daily activities independently
Early Complications of Amputation
    • 1. Infection:

      Infection may occur after any amputation surgery.

      • Superficial infections may resolve with antibiotic treatment.
      • Deep infections may require another surgery to remove dead and infected tissue.
      • In some cases, removing a few stitches at the surgical site can help drain secretions and improve infection control.

      2. Necrosis (Tissue Death) in the Stump:

      The stump is the remaining part of the amputated limb.

      • Sometimes, poor blood circulation in part of the stump can lead to tissue death and blackened skin.
      • The dead tissue must be surgically removed to prevent infection.

      3. Hematoma (Blood Collection):

      • A hematoma is a collection of blood within a closed space, usually caused by improperly sealed blood vessels.
      • In such cases, the hematoma must be drained, and the stump should be compressed with a bandage to prevent further bleeding.
      • If left untreated, a hematoma can increase the risk of infection.

      4. Blood Clots in the Limb’s Veins:

      To prevent deep vein thrombosis (DVT), patients may be prescribed anticoagulant medications as per the doctor’s recommendation.

Late Complications of Amputation
      • 1. Phantom Limb Sensation and Pain:

        Some patients continue to feel the presence of the missing limb, and in some cases, they may experience severe pain in the absent limb (phantom limb pain).

        2. Stump Pain:

        • Pain in the stump is caused by abnormal nerve growth at the amputation site.
        • Corticosteroid injections in the affected nerve may help reduce pain.
        • If pain persists, surgical removal of the nerve endings may be required.

        3. Joint Stiffness and Restricted Mobility:

        • If post-surgical stretching exercises are not performed correctly, the joint near the amputation site may become stiff and lose mobility.
        • Treatment involves physical therapy and stretching exercises to regain movement.
        • If therapy is unsuccessful, surgery may be needed.
        • Prosthetic limbs significantly aid the patient after healing.
Wound Care and Dressing
      • The type of wound care depends on the level of amputation:

        • Below-Knee Amputation:

          • The limb should be placed in a splint (orthosis) to maintain proper alignment.
          • Fluid drainage from the wound is necessary to prevent contractures, which can affect walking and the use of prosthetics.
        • Upper Limb Amputation:

          • The loss of arm function can make self-care activities such as eating, bathing, and hygiene maintenance more challenging.
Key Post-Amputation Care Guidelines
      • ✅ Use crutches or a walker for mobility.
        ✅ Follow a high-protein diet.
        ✅ Drink plenty of fluids.
        ✅ Keep the stump elevated above heart level to reduce swelling.
        ✅ Consider psychological counseling if needed.
        Change dressings daily.
        ✅ Report bleeding, fever, chills, or foul-smelling discharge immediately.