Facing Amputation

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Happy Patient

Are you facing amputation? We want to ensure you have all the information you need as you go into surgery. We will offer education on what to expect before and after surgery, the type of surgery you will undergo, and considerations for limb healing, rehabilitation programming and prosthesis design. 


Below Knee (Transtibial) Amputation
At this level, your surgeon will remove the foot and part of the lower leg (tibia and fibula bones), below the level of your knee. Your knee joint will remain intact after surgery, which results in a relatively long residual limb and is advantageous when walking with a prosthesis. A below knee (transtibial) prosthesis includes a prosthetic foot.


Above Knee (Transfemoral) Amputation
At this level, your surgeon will remove the foot, lower leg, knee, and part of the upper leg (femur bone), above the level of your knee. After this type of amputation, you will not have a natural knee joint, which results in a relatively short residual limb. An above knee (transfemoral) prosthesis includes a prosthetic knee as well as a prosthetic foot.


Through Knee (Knee Disarticulation) Amputation
At this level, your surgeon will remove the foot and entire lower leg by going through your knee joint. This means that the majority (or entire) part of your upper leg (femur bone) will remain intact, which results in a longer residual limb than at the above knee level. A through knee (knee disarticulation) prosthesis includes a prosthetic knee as well as a prosthetic foot.


Expected Timeline
One of the most frequently asked questions from new amputees is regarding how quickly they will get a prosthesis after surgery. While exceptions do apply, you can expect to spend 3-4 days in the hospital following your amputation. After this acute care stay, you will begin a rehabilitation program, as determined by your hospital team. The rehabilitation program could include staying at a rehabilitation facility or receiving home health services. Following rehabilitation, you will follow up with your surgeon in the office. Once your sutures have been removed, you will be able to schedule an appointment with the prosthetic clinic. You should expect your first prosthetic appointment to be an evaluation, at which point you and your Certified Prosthetist can discuss goals and determine a plan of care.

Care After Surgery
Like any surgical procedure, an amputation is traumatic for your limb and therefore requires dedicated care by you in order to heal properly and as quickly as possible. Additionally, you will need to prepare your limb for the greatest chance to not only receive a prosthesis but succeed in using one for your daily activities.

 

Caring for Your Surgical Wound

The cause(s) for your amputation affect the expected healing rate for your residual limb. However, by doing your best to ensure the surgical wound area is always clean, covered, and dry, you can help encourage healing.

  • DO change your dressing as instructed

  • DO wash your residual limb with mild soap and water after the incision is fully healed and all staples/stitches have been removed

  • DO use a soft towel to pat your residual limb dry after bathing

  • DO examine the skin on BOTH of your limbs every day using good lighting and a mirror to see the back and sides

  • DON'T remove scabs

  • DON'T soak your residual limb in water for long periods of time (e.g. DON'T take a bath)

  • DON'T apply any cream or lotion to your limb unless ordered by your care team

Reducing Swelling & Shaping Your Limb

Part of the preparation to receive a prosthesis includes reducing the swelling in your residual limb and creating a more smooth, uniform shape. The amount of swelling is influenced by multiple factors including medication, diet, and health conditions. However, in following your prescribed compression protocol, you can help reduce much of the swelling and shape the limb in the process.

  • DO elevate your limb

  • DO apply elastic compression wrap (e.g. ACE bandage) or wear a “shrinker” (special compression

  • stocking for residual limbs)

  • DO wear a postoperative sock

Preventing Muscle Contractures
Muscle contracture occurs when a muscle around a joint becomes very tight and does not allow the residual limb to move freely. With lower leg amputations, muscle contractures can occur at the hip and/or knee if the proper prevention measures are not taken. Contractures are difficult and painful to correct and can limit your ability to perform your daily activities or wear a prosthesis.

  • DO frequently change the position of your hip

  • When seated or lying down, DO keep your knee straight as possible (prop up if needed)

  • DO lay flat on your stomach (no pillow under you) for approximately 20 minutes 2-3 times per day

  • DON’T sit in a chair/stay in one position for long periods

  • DON’T hang your residual limb (amputated limb) over the side of the bed

  • When seated or lying down, DON’T place a pillow under your thigh, between your thighs