- What is Amputation?
- Effects of Amputation
- Candidates for Amputation
- Your Consultation
- The Amputation Procedure
- What are the types of amputation?
- When is amputation necessary?
- What is needed to lower the risk for possible complications in amputations?
- What are the post-treatment procedures and guidelines after an amputation?
- What are the possible complications to an amputation procedure?
- Are there any alternatives to amputation?
What is Amputation?
Amputation is a surgical procedure that includes the removal of a part or limb. These limbs or parts of your body are removed either because it is of no use to you anymore and even causes you pain, or it threatens your health due to infection. The most common parts of the body which are amputated include the arm, feet, leg or toe. Amputation is most considered by doctors as a last resort in any treatment.
Effects of Amputation
Amputation is performed to relieve pain; to stop blood loss and prevent infection after the limb undergoes severe damage; to prevent the spread of bone cancer; and to prevent the spread of gangrene as a complication to injuries, frostbite, diabetes, or any other sickness that causes impairment to blood circulation.
Amputations cannot be performed on patients with infection, heart failure, uncontrolled diabetes mellitus, or those with blood clotting disorders.
Candidates for Amputation
Some causes for amputation may include:
- Having diseases like blood clots, diabetes, blood vessel disease called peripheral vascular disease or PVD, or osteomyelitis (infection in the bones).
- Having traumatic injuries, especially on the arms.
- Needing amputation to remove tumors from muscles and bones.
During your consultation, the physician will do a physical examination on the condition of your limb or the part that is considered for amputation. The physician will then check you for fever, cool skin near your wound, extremely painful skin, wound odor and infected or non-healing sores or wounds. The physician will also perform tests to find out how well your blood circulation is to the limb or part considered for amputation, and also any blood clotting problems. It is during this time of your consultation that you must report any allergies to anesthesia, pain medications or antibiotics.
The Amputation Procedure
The procedure varies slightly depending on the part to be removed. Amputation is mostly a two-part procedure. The first part is the removal of the diseased tissue for the wound to heal properly. And the second part of the amputation involves the construction of a stump to allow the attachment of a prosthesis or artificial replacement part.
The procedure begins with the surgeon making an incision around the part to be amputated. The part is then removed and the bone is smoothed. A flap, which is constructed of muscle, connective tissue and skin, is closed over the bone with surgical stitches that stay for about a month, to cover the raw end of the bone. A cast or rigid dressing is usually applied and stays in place for about two weeks.
During the recovery period, medication is prescribed to relieve any pain, and antibiotics to prevent any infection. The stump should be moved once in a while to encourage good blood circulation.
Physical therapy and rehabilitation are usually done within 48 hours. Patients stay in the hospital would range from a few days to two weeks, depending on the severity of the amputation done and the patient’s overall health.
Rehabilitation after amputation is a long and arduous process, especially for above the knee amputees. Daily physical therapy done twice a day is usually recommended for patients. Also, psychological counseling is important for rehabilitation. There are a number of amputees who feel a sense of loss and grief when they lose a body part, while some are bothered by phantom limb syndrome which is a condition where they feel as if the amputated part is still in place or in even if it does not exist. Amputees are encouraged to join self-help groups, where they get to meet others who are also living with amputation, to help in addressing the emotional aspects of their amputation, and this often speeds their physical rehabilitation process and recovery.
Amputation procedures run the risk of complications like contracture or joint deformity, hematoma, gangrene, necrosis, wound opening or infections. All of these, however, can be treated by your physician. The need to undergo another treatment or amputation is quite rare.
What are the types of amputation?
The types of amputation are self-amputation or congenital amputation. Self-amputation occurs when a trapped person frees himself or herself by removing part or all of a body part, while congenital amputation is when a person is born without part or all of a body part.
When is amputation necessary?
Amputations are usually necessary for those having traumatic injury, peripheral vascular disease, and malignant tumors.
What is needed to lower the risk for possible complications in amputations?
Amputations require a complete health assessment to check for infections, blood sugar abnormalities, use of blood thinning medications, allergies to anesthesia, pain medications, or antibiotics to prevent any complications after the procedure.
What are the post-treatment procedures and guidelines after an amputation?
Patients are likely to remain in the hospital for at least 5 to 14 days after the amputation procedure. Medications for pain and antibiotics are prescribed when needed. Psychological counseling, letting amputees join self-help groups or drug therapy are encouraged to address their emotional recovery. Physical therapy is usually started within 48 hours after the amputation procedure. Practice with a prosthetic device begins as early as 10 to14 days after amputation.
What are the possible complications to an amputation procedure?
Complications after amputation include contractures or a fixed joint deformity, hematoma, gangrene, necrosis or death of the skin flap, wound opening, and a 5 to 15 percent rate of mortality.
Are there any alternatives to amputation?
Alternatives to amputation depend on the medical cause underlying the decision to amputate and the degree of medical urgency. Drug therapy may be considered as an alternative in specific cases, like the development of foot ulcers as a complication of diabetes. Some studies have suggested non-surgical treatment of diabetic foot ulcers with a new, recombinant drug called Becaplermin/Regranex. This drug, combined with competent ulcer nursing, leads to fewer amputations necessary.