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.
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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.
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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.
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Your
Consultation
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.
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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.
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Recovery
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.
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Risks
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.
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Frequently Asked
Questions
Q:
What are the types of amputation?
A:
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.
Q:
When is amputation necessary?
A:
Amputations are usually necessary for those having traumatic
injury, peripheral vascular disease, and malignant tumors.
Q:
What is needed to lower the risk for possible
complications in amputations?
A:
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.
Q:
What are the post-treatment procedures and guidelines
after an amputation?
A:
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.
Q:
What are the possible complications to an amputation
procedure?
A:
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.
Q:
Are there any alternatives to amputation?
A:
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.
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