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Amputation—General Overview

by Patricia Griffin Kellicker, BSN

Definition

Reasons for Procedure

Possible Complications

What to Expect

Call Your Doctor

En Español

Definition

An amputation is a surgery to remove a body part. It is removed because of disease or damage.

Below-the-Knee Amputation

Reasons for Procedure TOP

An amputation is typically done for one of the following reasons:

Peripheral artery disease (PAD) causing:
- Gangrene
- Untreatable pain
- Severe soft tissue infection
Severe trauma that cannot be repaired
Complications of diabetes
Untreatable bone infection such as osteomyelitis
Malignant tumor
Congenital deformity (present at birth)
Severe frostbite
Complications of connective tissue diseases, such as:
- Systemic lupus erythematosus
- Scleroderma

Possible Complications TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Poor healing at amputation site, resulting in the need for a higher level of amputation
Skin breakdown
Infection
Bleeding
Swelling at surgical site
Phantom limb pain —feeling pain in amputated limb area
Phantom sensation—feeling that amputated limb is still there
Blood clots
Complications of anesthesia

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:

Smoking
Drinking
Chronic diseases, such as diabetes or obesity

What to Expect TOP

Prior to Procedure

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:
Tissue cultures
Blood tests
Heart evaluation
Preoperative antibiotics
Tests 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.

Anesthesia

The anesthesia used 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.

Description of Procedure TOP

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.

How Long Will It Take? TOP

This procedure can take 20 minutes to several hours. The length will depend on the type of amputation being done and your overall health.

How Much Will It Hurt? TOP

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay TOP

Your hospital stay will depend on the type of amputation you had. Typically:

Foot or toe amputation: 2-7 days
Leg amputation: 2 days to 2 weeks or more
Upper extremity: 7-12 days
Finger amputation: 0-1 day

Your doctor may choose to keep you longer if complications arise.

Post-procedure Care TOP

At the Hospital

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 1-2 days 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 medications. This may include antibiotics or blood thinners.
You will be fitted with a prosthesis as soon as your wound has healed.

Preventing Infection

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

Washing their hands
Wearing gloves or masks
Keeping your incisions covered

There are also steps you can take to reduce your chance of infection, such as:

Washing your hands often and reminding your healthcare providers to do the same
Reminding your healthcare providers to wear gloves or masks
Not allowing others to touch your incision

At Home

Stitches will be removed within a few weeks of surgery. When you return home:

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.
Maintain a healthy body weight for overall health and to make sure your prosthesis fits well.

Call Your Doctor TOP

Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision sites
Increasing or excessive pain
Cough, shortness of breath, or chest pain
Severe nausea and vomiting

If you think you have emergency, call for emergency medical services right away.

RESOURCES:

American Diabetes Association
http://www.diabetes.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

Canadian Diabetes Association
http://www.diabetes.ca

The Canadian Orthopaedic Association
http://www.coa-aco.org

References:

Bone sarcoma in the upper extremity: treatment options using limb salvage or amputation. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
...(Click grey area to select URL)
Updated October 2007. Accessed December 5, 2014.

Fingertip injuries/amputations. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
...(Click grey area to select URL)
Updated August 2011. Accessed December 5, 2014.

Last reviewed November 2015 by Donald Buck, MD
Last Updated: 12/20/2014

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