Amputation is a surgery to remove a limb or part of a limb. It is done because tissue in the limb is diseased or damaged and can’t be healed. The surgeon saves as much of your limb as possible. This may include joints, such as the knee. But you may not know before the surgery how much of the limb will remain. Amputation is intended to restore your ability to function. This is because removing your diseased or damaged limb can improve your health. Common causes of amputation include peripheral artery disease that causes ischemia, trauma, diabetes, infection, and cancer.
You' will receive either general anesthesia or a local/regional anesthesia. The surgeon divides damaged tissue from healthy tissue. This includes skin, muscle, bone, blood vessels, and nerves. Then the surgeon removes the damaged part of the limb. The remaining nerves are cut short and allowed to pull back into the healthy tissue. This protects and cushions them. The end of the cut bone is trimmed and the edges are smoothed for comfort. A flap of healthy muscle and skin is left behind when the damaged tissue is removed. The flap is brought snugly over the bone to cover the end of the amputated limb. If there isn’t enough tissue in the flap, the surgeon takes skin or tissue from another part of the body. The flap is then sutured or stapled in place. The wound may be left open at first if debris is present or infection is possible. This allows fluid to drain and helps the wound heal cleanly. The wound will later be closed by the surgeon.
Further surgery needed to remove more of the limb
Hemorrhage (severe bleeding)
Pain, including nerve-related symptoms, chronic pain, and phantom limb pain
Heart problems (heart attack, arrhythmias, heart failure0
When you wake up, you’ll be on pain medication to help keep you comfortable. It will likely be given along with fluids through an IV line that’s placed in a vein. Later, you’ll be switched to oral pain medications as needed. You’ll have a splint or some other form of pressure dressing on your residual limb. This helps control swelling and aid healing. You may be started on medicine to prevent blood clots depending on your surgery. You will receive antibiotics just before surgery. These may continue after surgery, as well. You may have a urinary catheter for a short time.
You’ll stay in the hospital for 3 to 7 days. Your stay may be longer or shorter. This will depend on your overall health and how quickly you heal. While in the hospital, you’ll begin physical therapy. This will help stretch and strengthen your muscles. It will also help prevent shortening of muscle or joint tightening (contracture). You’ll learn how to safely transfer between your bed and other surfaces, such as a chair. This helps prevent falls so that your healing wound is protected. Later, you may be able to move around using a walker or crutches, if your surgery was on a lower limb. You may work with an occupational therapist. He or she can help you resume tasks, such as showering and dressing.
You’ll be ready to go home when your pain is controlled by oral medications. You’ll also need to be able to move safely between surfaces. If you’re having trouble with these tasks, you may need further help. This may mean going to a nursing center or a rehabilitation unit, if your amputation was on the lower limb, If your surgery was on a lower limb, you’ll likely go home in a wheelchair. It may have an amputee board (a special platform) to support your residual limb.
At home, you’ll need to keep doing the exercises you were taught in the hospital. This will help prepare your residual limb to be fitted for a prosthesis (artificial limb). At all times, take care to move around safely to avoid falls. Falling can reopen your wound. Use your wheelchair, walker, or crutches at all times, if you received them.
You’ll need to follow up with the surgeon about 5 to 7 days after you go home. The surgeon will check how your wound is healing. The sutures or staples will likely come out about 2 to 3 weeks after surgery. This could be longer if you heal more slowly due to other health problems. After healing is complete, you may be able to be fitted for a prosthesis.
Check your wound at home as directed by the surgeon. Call your surgeon right away if you have any of the following problems:
Fever of 100.4ºF (38.0°C) or higher
Red streaks on the skin around the wound
Thick, cloudy, or yellow-brown drainage or odor from the wound
Wound separation (skin pulls apart)
Severe increase in pain