An amputation is a surgery to remove a body part. It is removed because of disease or damage.
Above the Knee Amputation
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An amputation is typically done for one of the following reasons:
Peripheral arterial disease
GangreneUntreatable painSevere soft tissue infectionSevere trauma that cannot be repairedComplications of diabetes
Untreatable bone infection (osteomyelitis)
Malignant tumorCongenital deformity (present at birth)
Complications of connective tissue diseases, such as:
If you are planning to have an amputation, your doctor will review a list of possible complications, which may include:
Poor healing at amputation site, resulting in the need for a higher level of amputationSkin breakdownInfectionBleedingSwelling at surgical sitePhantom limb pain—feeling pain in amputated limb area
Phantom sensation—feeling that amputated limb is still thereBlood clotsComplications of anesthesia
Some factors that may increase the risk of complications include:
Peripheral vascular diseaseDiabetesObesityInfectionProlonged immobilityHeart diseaseSmoking or lung diseaseBlood clotting disordersCertain medicines (eg, steroids)
Your amputation may be planned. In this case, your doctor will review with you how it is done and what to expect. An emergency amputation may need to be done. This can happen because of trauma or life-threatening infection. In this case, you may not have this preparation.
Depending on the injury and location, your doctor may do some of the following before your surgery:
Imaging studies to look at the bones and surrounding tissue for evidence and location of disease or trauma, including:
X-raysCT scanMRI scanBone scanTissue culturesBlood testsHeart evaluationPreoperative antibioticsTests to evaluate blood flow in the part of the body that is being amputated
Leading up to your surgery:
Arrange for a ride home from the hospital.Arrange for help at home after your surgery.Follow instructions for eating before surgery—usually nothing after midnight.You may be asked to use an antibacterial soap the morning of your surgery.
This will depend on the body part operated on. You may receive:
General anesthesia—You will be asleep.
Local anesthesia—A specific area will be numbed.Spinal anesthesia—Your lower body will be numb.
An incision will be made into the skin of the affected limb or limb part. If needed, the muscles will also be cut. Blood vessels will be tied off or sealed to prevent bleeding. The bone will then be cut through. The diseased or damaged body part will be removed.
Muscle will be pulled over the bone. It will be sutured in place there. The remaining skin will be pulled over the muscle. The skin will be sewn to form a stump. A sterile dressing will be placed over the incision.
If severe infection is involved, the incision may be left open to heal.
This procedure can take 20 minutes to several hours. The length will depend on the type of amputation being done and your overall state of health.
During the surgery, anesthesia will block any pain. After surgery, you will feel pain as you begin to heal. Your doctor will give a medicine to help manage pain. You may feel phantom pain, which is a feeling of pain in the amputated portion of the limb that is no longer present. If you do, tell your doctor so it can be treated.
Your hospital stay will depend on the type of amputation you had. Typically:
Foot or toe amputation: 2-7 daysLeg amputation: 2 days to 2 weeks or moreUpper extremity: 7-12 daysFinger amputation: 0-1 day
Your doctor may choose to keep you longer if complications arise.
After surgery, you can expect some of the following:
The area involved will be elevated. This will decrease swelling.Your limb will be dressed in bulky dressing, elastic bandage, or cast.You will be encouraged to get up and walk as soon as possible.Physical therapy will begin within a day or two of surgery. It will focus on improving strength and mobility.You may wear a cast or special shoe for toe/foot amputations.You may be given certain medicines. This may include antibiotics or blood thinners.You will be fitted with a prosthesis as soon as your wound has healed.
Stitches will be removed within a few weeks of surgery. When you return home, do the following to help ensure a smooth recovery:
Follow the instructions for keeping your
Follow instructions on how to care for your prosthesis.Counseling may be recommended for the emotional trauma of an amputation.Attend follow up appointments with your doctor. They will make sure you are healing well.Check with your doctor about which medicines to take at home.Maintain a healthy body weight for overall health and to make sure your prosthesis fits well.
Keep your blood vessels healthy:
If you smoke, quit. Smoking can interfere with healing.Avoid foods that are high in fat and cholesterol.If you are diabetic, check your blood sugar levels and eat right.Exercise regularly.
Also, ask your doctor about when it is safe to shower, bathe, or soak in water.
After you leave the hospital, call your doctor if any of the following occurs:
Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision sitesIncreasing or excessive painCough, shortness of breath, or chest painSevere nausea and vomiting
In case of an emergency, call for medical help right away.
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http://www.vascularweb.org/patients/NorthPoint/Amputation.html. Accessed November 17, 2008.
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http://healthlibrary.epnet.com/GetContent.aspx?token=D39207C8-9100-4DC0-9027-9AC6BA11942D&chunkiid=14763. Accessed November 17, 2008.
Amputation of the hand or finger and prosthetics. American Society for Surgery of the Hand website. Available at:
http://www.assh.org/Content/NavigationMenu/PatientsPublic/HandConditions/AmputationandProsthetics/Amputation_and_Pros.htm. Accessed November 17, 2008.
Badash M. Amputation, Above the knee. EBSCO Health Library website. Available at:
http://healthlibrary.epnet.com/GetContent.aspx?token=D39207C8-9100-4DC0-9027-9AC6BA11942D&chunkiid=14822. Accessed November 17, 2008.
Bone Sarcoma in the Upper Extremity: Treatment Options Using Limb Salvage or Amputation. American Academy of Orthopaedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00092#Rehabilitation/Convalescence. Accessed November 18, 2008.
Buerger’s disease: what is it? Vascular Disease Foundation website. Available at:
http://www.vdf.org/diseaseinfo/buergers. Updated October 31, 2008. Accessed December 16, 2008.
Fingertip injuries/amputations. American Academy of Orthopaedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00014. Accessed November 18, 2008.
Last reviewed December 2012 by John C. Keel, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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