When taking a bath, avoid leaving your stump submerged in water for long periods because the water will soften the skin on your stump, making it more vulnerable to injury. If your skin becomes dry, use a moisturising cream before bedtime or when you're not wearing your prosthesis. Some people find wearing one or more socks around their stump helps absorb sweat and reduces skin irritation. The size of your stump may change as the swelling goes down, so the number of socks you need to use may vary.
You should change the socks every day. Contact your care team for advice if you think you may be developing a skin infection. After having a leg or foot amputated, it's very important to avoid injuring your remaining "good" leg and foot, particularly if your amputation was needed because of diabetes. Your remaining leg and foot may also be at risk. Avoid wearing poorly fitting footwear and ensure that an appropriately trained healthcare professional, such as a podiatrist, is involved in the care of your remaining foot.
You should also be offered a regular review of your foot by a foot care team. Find out more about diabetes and foot care. Like any type of operation, an amputation carries a risk of complications. It also carries a risk of additional problems directly related to the loss of a limb. There are a number of factors that influence the risk of complications from amputation, such as your age, the type of amputation you've had, and your general health.
The risk of serious complications is lower in planned amputations than in emergency amputations. In some cases, further surgery may be needed to correct problems that develop or to help relieve pain. For example, if neuromas thickened nerve tissue are thought to be causing pain, the affected cluster of nerves may need to be removed. Many people who have an amputation experience some degree of stump pain or "phantom limb" pain. Stump pain can have many different causes, including rubbing or sores where the stump touches a prosthetic limb, nerve damage during surgery and the development of neuromas.
Phantom limb sensations are sensations that seem to be coming from the amputated limb. Occasionally, these can be painful phantom limb pain. The term "phantom" does not mean the sensations are imaginary. Phantom limb pain is a real phenomenon, which has been confirmed using brain imaging scans to study how nerve signals are transmitted to the brain.
The symptoms of phantom limb pain can range from mild to severe. Some people have described brief "flashes" of mild pain, similar to an electric shock, that last for a few seconds. Others have described constant severe pain. Stump and phantom limb pain will usually improve over time, but treatments are available to help relieve the symptoms.
There are several non-invasive techniques that may help relieve pain in some people. They include:. Research has shown that people who spend 40 minutes a day imagining using the part of their limb that was amputated, such as stretching out their "fingers" or bunching up their "toes", experience a reduction in pain symptoms. This may be related to the central theory of phantom limb pain. Researchers think the brain looks to receive feedback from an amputated limb, and these mental exercises may provide an effective substitute for this missing feedback.
Another technique, known as mirror visual feedback, involves using a mirror to create a reflection of the other limb. Some people find that exercising and moving their other limb can help relieve phantom pain. The loss of a limb can have a considerable psychological impact. Many people who've had an amputation report emotions such as grief and bereavement, similar to experiencing the death of a loved one.
Coming to terms with the psychological impact of an amputation is therefore often as important as coping with the physical demands.
Having an amputation can have a considerable psychological impact for three main reasons:. Negative thoughts and emotions are common after an amputation. This is particularly true in people who've had an emergency amputation because they don't have time to mentally prepare for the effects of surgery.
Common emotions and thoughts experienced by people after an amputation include:. People who've had an amputation as a result of trauma particularly members of the armed forces also have an increased risk of developing post-traumatic stress disorder PTSD. Talk to your care team about your thoughts and feelings, particularly if you're feeling depressed or suicidal. You may need additional treatment, such as antidepressants or counselling , to improve your ability to cope after having an amputation.
Being told you need to have a limb amputated can be a devastating and frightening experience. Adjusting to life after an amputation can be challenging, but many people enjoy a good quality of life once they have managed to adapt. There are a number of charities that can provide advice and support for people living with amputations, which include:.
Page last reviewed: 12 August Next review due: 09 August In doing the amputation, the surgeon seeks to remove all dead or dying tissue. Goals of amputation are to relieve pain, encourage wound healing, and increase a person's ability to carry out his or her daily activities.
Amputations and bypass grafting surgery may be planned at the same time to achieve the best results. For example, a person who has gangrene may have an amputation of part of the foot or leg while also having bypass grafting in an attempt to preserve still-living tissue.
Preoperative care before amputation is similar to any major surgery. People with major medical problems, such as diabetes or heart, lung, or kidney problems must be carefully assessed and their medical care optimized before the operation.
The importance of the preoperative evaluation cannot be overemphasized. People who have amputations are often chronically or seriously ill. And their risk of dying around the time of the operation as well as in the following years is higher than for other people of the same age. The appropriate amputation level depends on a number of factors, including why the amputation is needed, the general health of the person, the possibility for recovery and rehabilitation rehab , and the probability of adequate wound healing.
The aim of an amputation is to remove all dead and dying tissue while creating the most useful limb for recovery and rehab. It is very important to make sure that an artificial limb, if desired, can be appropriately fitted.
A below-the-knee amputation is usually preferable. It provides better mobility. Even if a person is very unlikely to be able to walk because of their general health or other medical conditions, a below-the-knee amputation provides for easier transfers and movement while in bed.
Walking on an above-the-knee prosthesis artificial limb requires a lot more energy than walking on a below-the-knee prosthesis, although young, relatively healthy people manage much better than older, more frail people do. But when a below-the-knee amputation cannot be done, an above-the-knee amputation has the advantage of easier healing.
Sometimes a bypass grafting operation may be done to allow a below-knee amputation site to heal adequately. Methicillin-resistant staphylococcus aureas MRSA , also a bacterium, can cause a severe condition called necrotizing soft tissue infection , or fasciitis.
This is not a procedure, but a term that refers to a missing or incompletely formed hand, foot, arm or leg that is present at birth. The surgical approach depends on the affected body part, the reason for the amputation and the extent of bone and tissue damage. A finger amputation may be a small but intricate procedure working with skin, tendons and nerves to allow fine motor function and optimal use of the hand.
The removal of an arm or leg can call for major surgery, requiring skill in handling and stabilizing all the different tissues of the body part including skin, blood vessels, muscles, nerves, tendons and bone. To remove a finger, toe, foot, hand, arm or leg, the surgeon may cut through the bone or detach disarticulate a joint, separating bones where they meet such as in the knee or elbow. The amputation may take place in stages. A revision procedure may be necessary to address tissue breakdown, chronic pain, scarring or other health issues.
Orthopaedic and orthopaedic oncologic surgeons work with a plastic and reconstructive surgeon, along with a range of nurses and surgical technologists, to perform a surgical amputation procedure. Together, they remove the diseased or damaged body part, and then work with the remaining bone and soft tissue to shape the stump. The surgical team may form the soft tissue at the end of the limb to help accommodate a prosthetic, or leave bone in place for subsequent osseointegration OI.
If the rehabilitation care plan includes a prosthetic artificial device, the amputation should ensure that a prosthesis fits and functions properly. The surgeons remove the limb, and anchor muscles to the cut end of the bone and cover it with skin. Surgeons remove a body part and insert a steel implant into the stump of the leftover bone.
A prosthetic can attach to that implanted piece. When used for a leg amputation, this procedure can enable the leg and hip bones to absorb weight bearing instead of the soft tissue left behind, so standing and walking feel more natural to the patient. During rotationplasty , which might be a choice for some patients with a tumor in bone or soft tissue, surgeons remove the part of the limb where the cancer is, and any healthy tissue below the tumor is turned around and re-attached.
A rotationplasty can rotate the lower leg and re-connect it so that what was the ankle joint becomes a substitution for the knee. Successful rotationplasty can allow some patients to use a prosthetic lower leg, and enjoy mobility and even participation in activities and sports.
The Johns Hopkins Hospital is one of the few places in the U. Working together, experts in orthopaedics, plastic surgery, prosthetics, rehabilitation, physical and occupational therapy, and mental health work with patients facing amputations of the thigh, leg or arm, including those with double both limbs amputations.
Whether or not you plan to use a prosthetic, the healing process and a customized rehabilitation plan can provide you with the best chance to resume your life activities. The post-amputation stump must be kept bandaged, clean and dry until the stitches sutures can be removed.
You and your doctor will check the surgical site for any areas that are open or not healing. When the initial bandaging comes off, the doctor may offer a compression device called a shrinker sock to prevent swelling in the stump as the blood vessels heal. This process helps prepare the stump for a prosthesis if using one is part of your plan.
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