Amputation

Specialty of Physical medicine & rehabilitation

What is it?

An amputation is the surgical removal of a part of the body, such as a whole limb or a portion of it, when other procedures have failed or are not possible due to your general state of health.

In modern medicine, amputations are a last resort measure to be used when other treatments are not successful. It is not to be confused with disarticulation (resection of muscles and ligaments) or with congenital amputation, which causes a limb not to develop during gestation due to a genetic anomaly.

Why is it done?

An amputation may be necessary under the following circumstances:

  • when it is the only option for malignant tumour resection
  • as a consequence of a severe trauma (for instance, a car accident)
  • to save a part of a limb which has gangrenous tissue

In this last case, an amputation may be necessary in case of embolised arteries, diabetes mellitus, frequent infections, Buerger’s disease, Raynaud syndrome or frostbite.

90% of amputations are associated with diabetes-induced conditions, and although it usually involves the feet or legs an amputation can also be performed on the arms, hands or fingers. According to data, 65,000 amputation surgeries are performed in the United Kingdom each year.

What does it involve?

Before the procedure, the doctor will verify exactly where the cut needs to be done and what is the best area to do the amputation. It is important to choose an area with good circulation, in order to facilitate the recovery process.

The procedure itself is done in several phases. First of all, the doctor will measure and restrict the blood flow of the designated limb as to avoid the risk of haemorrhaging. After that, the muscle tissue will be dissected in order to cut off the bone. Finally, the surgeon will close up by suturing the area.

The main complication of an amputation is getting an infection, which could force the surgeon to perform another amputation at a higher operation site. Although it is a major form of surgery with a potentially significant impact on life, there are specific prostheses available that allow people who had an amputation to live and walk normally.

How can I prepare for it?

You should bear in mind that this procedure isn't suitable for people who have an ongoing infection, heart condition, advanced diabetes mellitus or blood coagulation disorders. You will need to do several tests before the procedure to exclude these possibilities.

Post-operative progress

After the procedure, your doctor will prescribe you painkillers and antibiotics to avoid any potential risks of infection. Within a couple of days you’ll need to get started on physical therapy, so that you can move your stump and prosthesis in the best possible way. How long you’ll be in hospital for depends on where the amputation is made. In the most serious cases, when the operation site is above the knees, you could be in hospital for several weeks. You may also receive psychological support with the emotional impact of amputation, as well as the phenomenon of “phantom limb”, which can cause you to still feel the amputated limb is attached, or even feel pain from it.

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