Amputation is a surgery done to remove all or part of a limb or extremity like an arm, leg, foot, hand, toe or finger.
Reasons for Amputation
There are a lot of reasons an amputation may be carried out. The most common is reduced circulation because of damage or narrowing of the arteries, referred to as peripheral arterial disease. Without sufficient blood flow, the body's cells cannot get oxygen and nutrients they need from the bloodstream. Because of that, the affected tissue starts to die and infection may set in.
Other reasons for amputation may comprise:
Chronic injury (from a vehicle accident or serious burn, for example)
Thickening of nerve tissue, known as a neuroma
Cancerous tumor in the bone or muscle of the limb
Serious infection that doesn’t improve with antibiotics or other treatment
The Amputation Procedure
An amputation generally requires you to be in the hospital for 14 days or more, base on the surgery and complications. The process itself may vary, depending on the limb or extremity being amputated and the patient's general health.
Amputation may be performed under general anesthesia (meaning the patient is asleep) or with spinal anesthesia, which numbs the body from the waist down.
During an amputation, the surgeon takes away all damaged tissue while leaving as much healthy tissue as possible.
A doctor may use several methods to decide where to cut and how much tissue to remove. These include:
Checking for a pulse close to the place the surgeon is planning to cut
Put side by side with skin temperatures of the affected limb with those of a healthy limb
Looking for areas with swollen skin
Observing to see if the skin surrounding the place where the surgeon is planning to cut is still sensitive to touch
During the procedure itself, the surgeon will:
Remove the diseased tissue and any pieces of bone
Smooth uneven areas of bone
Seal off blood vessels and nerves
Arrange muscles so that the stump, or end of the limb, will be able to have a synthetic limb (prosthesis) attached to it
The surgeon may decide to close the wound right away by sewing the skin flaps (called a closed amputation). Or the doctor may leave the site open for several days in case there may be a need to remove additional tissue.
The surgical team then puts a sterile dressing on the wound and may place a stocking over the stump to hold drainage tubes or bandages. The doctor can as well place the limb in traction, in which a device holds it in position, or may use a splint.
Recovery From Amputation
The healing process from amputation is based on the kind of procedure and anesthesia used. In the hospital, the staff changes the dressings on the wound or teaches the patient to alternate them. The doctor observes wound healing and any conditions that would possibly interfere with healing, such as diabetes or hardening of the arteries. The doctor prescribes medications to relieve pain and assist prevent infection.
If the patient has problems with phantom pain (an experience of pain in the amputated limb) or grief over the lost limb, the doctor will prescribe medication and/or counseling, as necessary.
Physical therapy, starting with gentle, stretching exercises, often begins soon after surgery. Practice with the artificial limb might also begin as soon as 10 to 14 days after surgery.
Normally, the wound should heal fully in about four to eight weeks. It may take a long while to physical and emotional adjustment to losing a limb. Long-term recovery and rehabilitation will include:
Exercises to enhance muscle strength and control
Emotional support, including counseling, to assist with grief over the loss of the limb and
adjustment to the new body image
Activities to help restore the ability to perform daily tasks and promote independence
Use of artificial limbs and assistive devices.
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