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amputation

Alternative Names
limb removal

Definition
Amputation is a surgery to remove a limb or part of a limb. Amputation can also happen as an accident, which is called a traumatic amputation.

Who is a candidate for the procedure?
Amputation is most often used for one of four conditions:
  • gangrene, which is a severe limb infection with death of tissue
  • lack of enough blood flow through the arteries that supply blood and oxygen to the affected limb
  • severe trauma or injury of a limb
  • cancer or a tumour involving a limb
Amputation has serious emotional and physical effects. For this reason, limb removal is usually advised only when other options are not possible or have little chance of success.

How is the procedure performed?
There are many different ways to perform an amputation. A single finger or toe may be removed, or an entire arm or leg. The surgeon will usually try to remove as little of the limb as needed to treat the condition.

An amputation is done in an operating room. In many cases, general anaesthesia is used to put the person completely to sleep with medications. Regional anaesthesia may also be used. In this case, a person is awake but has no sensation of pain.

The area of skin where the incision will be made is cleaned. The surgeon then cuts into and through the skin. In most cases, the surgeon will remove the limb or part of the limb at a point where there is a joint. For instance, the entire leg below the knee may be removed. The knee area is chosen partly because this is where the shinbone, or tibia, meets the thighbone, or femur. Removing the part or whole limb at a joint prevents the need to break one of the bones.

After the part or whole limb is removed, the skin is closed with sutures. A bandage or dressing is then placed over it.

What happens right after the procedure?
The person is taken to a surgery recovery room while he or she wakes up from the surgery. Analgesia is given if needed. Antibiotics and other medications may also be given.

When the person is awake and his or her vital signs are within normal limits, he or she is usually taken back to a bed in the surgical inpatient unit. In most cases, the person will need to stay in the hospital for at least 1 or 2 more days.

What happens later at home?
In many cases, a person will need a prosthesis, or artificial body part, after surgery. The prosthesis can help a person continue to walk after limb removal. The new body part often requires a custom "fit." Physiotherapy to learn how to use the new limb is usually given. The area of the incision should be watched closely for signs of infection. These signs include increasing pain, warmth, or redness. Any new or worsening symptoms should be reported to the doctor.

What are the potential complications after the procedure?
The most common complications of amputation are:
  • phantom limb pain, a condition in which the person feels pain in the body part that is missing
  • stump pain, due to abnormal nerve growth at the site of surgery
Medication, more surgery, or another type of therapy may be needed for these types of pain.

Many of the people who need an amputation have poor circulation, diabetes, or both. These conditions interfere with healing. If healing does not occur, more surgery or other therapy may be needed in the future. As with any surgery, infection, bleeding, and allergic reactions to anaesthesia may also occur.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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