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What is amputation? — This is surgery to remove a damaged body part. Minor amputations remove small areas like a toe or finger. Major amputations remove a large part of the body, usually above or below a joint.
You might need an amputation if:
●Your body part was severely injured and cannot be fixed.
●You have an infection that might spread unless the body part is removed.
●You have very poor blood flow to a part of your body.
●You have a tumor.
●You have a painful "neuroma" – This is an abnormal mass of nerve tissue.
●You have frostbite – This is when a body part is damaged by cold.
The doctor will decide what tissue needs to be removed based on your condition. They will keep as much healthy tissue as possible.
How do I prepare for amputation? — In some cases, an amputation is an emergency surgery. In others, the doctor can schedule a time for your surgery. If you can schedule it, the doctor can help you prepare for what life will be like after.
Before your procedure, your doctor will do an exam. The doctor or nurse will tell you if you need to do anything special to prepare. They might send you to get tests, such as:
●X-rays or other imaging tests – These create pictures of the inside of the body.
●Lab tests
Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:
●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.
●Any allergies you have
●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.
You will also get information about:
●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.
●Lowering the risk of infection – In some cases, you might need to wash the area with a special soap.
●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover. You might need to use a walker, crutches, or wheelchair for a time after surgery.
Ask the doctor or nurse if you have questions or if there is anything you do not understand.
What happens during amputation? — When it is time for the procedure:
●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.
●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include:
•Regional – This type of anesthesia blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."
•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.
●You might get medicines to help control pain after the procedure.
●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.
●The doctor will remove tissue from your body part that is damaged, dead, or infected. They will leave as much healthy tissue as possible.
●In most cases, the doctor will close your cuts (incisions) and cover them with clean bandages. If a lot of the tissue is infected, the doctor might not stitch the wound closed.
●In some cases, the doctor will place a drain to get rid of extra fluid. The drain might stay in place for a few days.
●The procedure usually takes between 1 to 3 hours.
What happens after amputation? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.
As you recover:
●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.
●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.
●Prop the area where you had surgery on pillows, keeping it above the level of your heart, when sitting or lying down. This might help lessen pain and swelling.
●The staff will help you get out of bed and start moving around when you are ready. You might need to use a sling, crutches, or a walker when you move around, depending on what was amputated.
●You will get medicine to help with pain, if needed. You might need other medicines, too.
●When you are ready to eat, you might start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.
How long it takes to recover, and what you need to do, depends on what type of surgery you had. Some people can go home after an amputation. Others might spend 1 to 3 nights in the hospital. Or they might go to a rehabilitation, or "rehab," facility. At rehab or after you go home, you might work with a physical therapist (exercise expert). They can help you get stronger and improve your movement and balance.
What are the risks of amputation? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:
●Poor wound healing or spread of diseased tissue – This might require more amputation of the nearby area.
●Infection
●Bleeding or blood clots
●Nerve damage
●Phantom pain – This is a painful feeling that the amputated area is still there.
What else should I know? — Before you go home from the hospital, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.
Patient education: Amputation – Discharge instructions (The Basics)
Patient education: Amputation, below-the-knee (The Basics)
Patient education: Amputation of the foot or toe (The Basics)
Patient education: Frostbite (The Basics)
Patient education: Gangrene (The Basics)
Patient education: Peripheral artery disease and claudication (The Basics)
Patient education: Peripheral artery disease and claudication (Beyond the Basics)
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