Patient education: Amputation of the foot or toe (The Basics)

What is amputation? — This is surgery to remove a damaged body part.

You might need a toe or partial foot amputation if:

●Part of your foot was severely injured and cannot be fixed.

●You have an infection that might spread unless a part of your foot or toe(s) is removed.

●You have very poor blood flow to part of your foot.

●You have a tumor in your foot or toe.

●Your foot has a deformity.

●You have repeated diabetic foot ulcers that won't heal with other treatments.

●You toe(s) or foot has frostbite.

The doctor will decide what part of your foot needs to be amputated based on your condition.

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 will probably also 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.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will remove any tissue on your foot that is dead or infected. They will leave as much healthy tissue as possible.

●In rare cases, the doctor will place a drain to get rid of extra fluid.

●In most cases, the doctor will close your cuts (incisions) and cover them with clean bandages. If a lot of tissue is infected, the doctor might not stitch the wound closed.

●The procedure usually takes between 30 and 60 minutes.

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 your leg 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 be given a special shoe that lets you walk only using your heel. Or you might be told not to bear any weight and instead use crutches, a walker, or a wheelchair for a time.

●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. Many people can go home after toe or partial foot amputation. Others might spend 1 to 3 nights in the hospital. Or they might need to go to a rehabilitation, or "rehab," facility. At rehab or after you go home, you might also 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 amputation of more of the toes, or the entire foot.

●Infection

●Bleeding or blood clots

●Developing a "neuroma" where nerves were cut – This is an abnormal mass of nerve tissue.

●Phantom pain – This is a painful feeling that the toe(s) 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.

More on this topic

Patient education: Amputation of the foot or toe – Discharge instructions (The Basics)
Patient education: Amputation (The Basics)
Patient education: Frostbite (The Basics)
Patient education: Gangrene (The Basics)
Patient education: Peripheral artery disease and claudication (The Basics)
Patient education: Foot care for people with diabetes (The Basics)
Patient education: Diabetic foot ulcer (The Basics)

Patient education: Peripheral artery disease and claudication (Beyond the Basics)
Patient education: Foot care for people with diabetes (Beyond the Basics)