The process of surgically removing a part of the entire extremity, which includes the leg, foot, finger, toe, hand, and arm, is called amputation. The most common type of which is the leg amputation, which can either be below or above the knee for surgery.
The Procedure for Amputation
The point of this procedure is for the surgeon to remove all tissues that are damaged but leaving as many healthy tissues as possible. The surgeon may use any of the two types of anaesthesia available, and these are: general anaesthesia, wherein the patient will be put to sleep, and the other one is the spinal anaesthesia, where only from the waist down of the patient is numbed.
Depending on the type of surgery performed and if there are complications involved, the length of stay of the patient in the hospital is usually around 5 to 14 days. The surgery will depend on the patient’s condition and the limb to be removed.
There are different ways for the surgeon to assess where to cut and how much tissue is to be removed.
- The surgeon will check for the pulse that is close to what will be removed
- The skin temperature of the damaged extremity will be compared to the healthier one
- The surgeon will search for reddened skin
- The doctor will see if the skin close to the area that will be removed is still sensitive to touch
During the surgery, the surgeon will do the following:
- He or she will remove the injured tissue and if there are any crushed bones
- The uneven areas of the bone will be smoothened out
- The doctor will seal off nerves and blood vessels
- The muscles will be cut and shaped so that the patient will be able to attach an artificial limb if he or she wishes to.
Causes for the Loss of an Extremity
An amputation can be an inevitable procedure because of several reasons. Still, the most usual reason is due to poor circulation, and this condition is known as peripheral arterial disease, which is about narrowing or damaging the arteries.
If the blood is not able to flow properly in the bloodstream, the oxygen and the nutrients that the cells of our body need will not be sufficient, this will then affect the tissue and will lead to infection or its death.
Some other reasons for amputation are:
- Severe injury resulting from incidents or accidents such as serious burn, vehicular accident, and the like
- If there is a tumor in the muscle of the limb or the bone
- If a severe infection is present and antibiotics or other types of treatment do not work
- If there is a condition called neuroma which involves the thickening of nerve tissue
- If the person is experiencing severe frostbite
Diagnosis and Treatment for Loss of Limb
Once it is decided that amputation is highly necessary for your condition, there are some things that you need to prepare for. And this includes preparing yourself and your home before the procedure as well as after.
Before the surgery, here are some things that you need to keep in mind:
- If the operation is planned and scheduled ahead of time, you must inform your doctor about all the medications that you have, which includes vitamins, supplements, herbal, prescription, non- prescription, over- the- counter, etc. You also need to tell your doctor if you have been consuming alcohol.
- Days prior to your surgery, you may need to stop taking certain medicines that will make it hard for the blood to clot. Some of these drugs include ibuprofen, such as Advil or Motrin, warfarin like Coumadin, and other medicines with the same nature.
- You need to discuss with your doctor about which medications you can continue taking before the surgery. Also, if you are a smoker, stop smoking.
- If you have diabetes, continue with your regular diet and follow your regular medicine schedule for diabetes.
- Most likely, you will be asked not to drink or eat anything for about 8 to 12 hours before your scheduled surgery. And if ever you need to take any medicine, you can take it for as long as you only sip a small amount of water.
- Before the surgery, it is essential that you also prepare your home to avoid many inconveniences for you.
Preparing the home before surgery
- Determine what kind of help you will need when you come home after the procedure
- Ask help from your family, neighbors, or friends to assist you while you are recovering. If there is no one available, you may ask your healthcare provider for a home health aide who can come to your home
- Make sure to fix all the tripping hazards like rugs, cables, wires, etc. Make your bathroom and the entire house safe for you to move around
- Make sure that getting in and out of your home will be safe for you
After the surgery
The end of your limb will have a bandage and will be dressed, and will stay that way for a minimum of 3 days. It is also normal if you feel some pain days after the procedure. For this, you will be given pain relievers to ease your discomfort.
It is also expected that you may have a tube that will drain fluids coming from the wound. This though, will be removed after some days.
Before you are sent home, you will be taught some things to make moving around more comfortable for you. You will learn these things:
- How to use a walker or a wheelchair
- How to strengthen your muscles through stretching
- How to make your arms and legs stronger
- How to walk with parallel bars and walking aids
- How to move around the bed and get into your chair
- How to keep your joints mobile
- How to sit or lie down in various positions to prevent your joint from becoming stiff
- How to manage the swelling in the area around the amputated part
- How to put the allowed weight on your residual limb.
You will be advised not to put on weight on the residual limb until it has fully recovered.
Replacing the amputated area with a prosthesis may happen only when your wound is almost healed, and if the surrounding area is not sensitive to touch anymore.
What are the normal conditions
An essential part of the recovery process is physical rehabilitation. This process can be daunting, tedious, and even frustrating for the patient, but it is something that needs to be worked on so that the individual may still be able to do his or her normal activities and remain active. If the patient can do this successfully, he or she can go back to work and keep doing his or her regular activities.
A patient’s rehabilitation program will be suited to his or her needs and will try to achieve the goal of allowing the patient to continue his or her regular activities. If all is not possible, then at least most of his or her daily tasks.
The patient will work with a physiotherapist and an occupational therapist. They will help you plan what to accomplish in your rehabilitation program, and at the same time, help you set realistic goals.
This program usually begins some days after the surgery. And it usually starts by doing simple exercises that you can do while sitting or lying down. If your surgery were a leg amputation, you would be asked to move around using a wheelchair. You will learn some “transfer techniques” to enable you to move around easily, and part of this is learning how to get into the wheelchair from the bed.
When your wound is almost healed, the physiotherapist will begin the exercise program with you to sustain your mobility as well as to strengthen your muscles.
If you have a prosthetic limb, your physiotherapist will also teach you how to use it, such as walking with a prosthetic leg or how to grip using a prosthetic hand.
Risks of having loss of limb
This type of surgical procedure is always risky, and as in any other kind of surgery, some risks come.
The risks involved in any surgery are:
- Having blood clots in the legs that may reach the lungs
- Breathing problems
The risks that come with this type of procedure are:
- The experience of phantom sensation, wherein you feel that the limb is still there, and also the experience of phantom pain.
- Having joint contracture, where the joint that is closest to the amputated part loses its range of motion thus giving the patient a harder time to move
- If an infection of the bone or skin develops
- If the wound does not heal completely and properly
Seeking Medical Help
Approximately 65% of amputation cases can be prevented. This can happen through early detection and quick treatment of the damaged area. There are some signs though to watch out for that will put you at risk for loss of limb.
These signs are:
- Infection in the limb that does not respond to antibiotics
- Numbness or intense pain in the limb even if you are at rest
- Smooth, shiny and dry skin on the limb
- Sores that do not heal
- Weakened or absence of a pulse in the limb
- Thickening of nails
Seek medical help immediately if you have diabetes or peripheral arterial disease, and you experience these symptoms so that amputation may be prevented.