Amputations

Amputation is a surgical procedure that involves removal of an extremity or limb (leg or arm) or a part of a limb (such as a toe, finger, foot, or hand), usually as a result of injury, disease, infection or surgery (to remove tumors from bones and muscles). Amputation of the leg (above and below-knee) is the most common type of amputation surgery performed.

For more information on amputation surgery call Christian Hospital at 314.747.9355 or toll-free at 877.747.9355 or email us.

Why are Amputations Done?

The most common reason for an amputation is poor circulation. The lack of circulation is caused by narrowing of or damage to the arteries, also known as peripheral artery disease. Peripheral artery disease (PAD) most frequently occurs in persons between the ages of 50 to 75 years and usually results from diabetes or atherosclerosis. PAD-related causes account for up to 90 percent of all amputations.

Other indications for amputation include a traumatic injury, such as severe burn or accident, or a cancerous tumor in a limb. Trauma is the leading indication for amputations in younger persons.

Amputation may also be performed for acute or chronic infections that do not respond to antibiotics or surgical debridement (removal of dead or damaged tissue). In some cases, an amputation procedure may be performed due to neuroma (a thickening of nerve tissue that may develop in various parts of the body), frostbite, or arterial blockage.

There may be other reasons for your doctor to recommend an amputation.

What are the Risks of Amputation?

Patients with diabetes, heart disease, or infection have a higher risk of complications from amputation than persons without these conditions. Serious traumatic injury increases the risk of complications. In addition, persons receiving above-knee amputations are more likely to be in poor health; therefore, these surgeries can be riskier than below-knee amputations.

As with any surgical procedure, complications can occur. Some possible complications that can occur specifically from an amputation procedure include a joint deformity, a hematoma (a bruised area with blood that collects underneath the skin), infection, wound opening, or necrosis (death of the skin flaps).

Deep vein thrombosis and pulmonary embolism pose a risk after an amputation primarily due to prolonged immobilization after surgery.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

During the Amputation Procedure

An amputation usually requires a stay in the hospital. Amputation surgeries may vary depending on the type of amputation, your condition and your doctor's practices. An amputation may be performed while you are asleep under general anesthesia or while you are awake under spinal anesthesia. If spinal anesthesia is used, you will have no feeling from your waist down. Your doctor will discuss this with you in advance.

Generally, an amputation follows this process:

  1. To determine how much tissue to remove, the doctor will check for a pulse at a joint close to the site. Skin temperatures, color and the presence of pain in the diseased limb will be compared with those in a healthy limb.
  2. After the initial incision, it may be decided that more of the limb needs to be removed. The doctor will maintain as much of the functional stump length as possible. The doctor will also leave as much healthy skin as possible to cover the amputated area.
  3. If the amputation is due to trauma, the crushed bone will be removed and smoothed out to help with the use of an artificial limb.
  4. After completely removing the dead tissue, the doctor may decide to close the flaps (closed amputation) or to leave the site open (open flap amputation). In a closed amputation, the wound will be sutured shut immediately. In an open flap amputation, the skin will remain drawn back from the amputation site for several days so any infected tissue can be cleaned off. At a later time, once the tissue is clean and free of infection, the skin flaps will be sutured together to close the wound.

For more information on amputation surgery call Christian Hospital at 314.747.9355 or toll-free at 877.747.9355 or email us.

After an Amputation Surgery

After an amputation, depending on your particular situation, you may remain in the hospital for several days. You will receive instructions as to how to change your dressing. You will be discharged home when the healing process is going well and you are able to take care of yourself with assistance.

After surgery, you may experience emotional concerns, such as grief over the lost limb or a physical condition known as phantom pain (a sense of feeling pain or sensation in your amputated limb). If this is the case, you may receive medications or other types of nonsurgical approaches.

You will receive detailed instructions as to how to care for the surgical site, dressing changes, bathing, activity level and physical therapy. It is important to follow the instructions given to you by your doctor.

Notify your doctor to report any of the following:

  • Fever and/or chills
  • Redness, swelling, or bleeding or other drainage from the incision site
  • Increased pain around the amputation site
  • Numbness and/or tingling in the remaining extremity

For more information on amputation surgery call Christian Hospital at 314.747.9355 or toll-free at 877.747.9355 or email us.