Leg Amputation- The Basics

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What and why do amputations happen and what to expect before and after your surgery. 

 

If an amputation has become necessary in your life, then you may be feeling a whirlwind of emotions; overwhelmed, anxious or even lonely. Some have the chance to prepare for it, while others don't, but it's important to know, you are not alone. In fact, there are more than 1 million annual limb amputations globally- that's one every 30 seconds. Further, below-knee amputations are the most common, representing 71% of vascular amputations in the world. Let's start with the basics. 

 

About Amputations

An amputation is the surgical removal of all or part of a limb or extremity. Amputation of the leg can occur below the knee (BK) or above the knee (AK) depending on your respective condition. There are many reasons an amputation may be necessary.  The most common being vascular disease (diabetes and peripheral arterial diseases), which makes up 54% of all amputations.  In these cases, damage or narrowing of the arteries causes poor circulation, leaving the body's cells without sufficient oxygen and nutrients that they need. As a result, the affected tissue begins to die and infection may set in. Other causes include trauma (45%) and cancer (less than 2%). Often, the decision to amputate your leg is one that is made only after all other attempts to save the leg have failed and when it is necessary in order to save or improve a person's life. 

 

Preparing for Surgery 

The more knowledge you have about your surgery and recovery, the more at ease you will feel. Remember, as a patient you play a vital role in the decision-making process of your care. If your amputation is scheduled and not an emergency related to trauma, the surgeon will conduct a physical and medical assessment and brief you on the details of your respective surgery. This is a good time to source and meet with a prosthetist to discuss limb length and rehabilitation expectations. When finding a prosthetist consider their credentials, training, experience and the location and accessibility of their office. This will be a person you meet with quite often so accessibility is quite important. Beyond a surgeon and prosthetist, your team will consist of a group of professionals comprising a surgeon, nurses, anaesthesiologist, physical/occupational therapist (PT/OT), and a prosthetist at the least. Your surgical and rehabilitation team is there to support you the best way they can so if you can, meet with each person and get to know how they will play their part.  Some important topics to discuss with your team: 

  • Medications you are currently taking that could interfere with the success of your surgery/ rehabilitation
  • Type of proposed surgery and type of anaesthesia that will be used 
  • Pain management plan
  • Type and duration of rehabilitation 
  • Prosthetic options 
  • Short and long-term goals post surgery 

During your pre-operative visits, you will run through several tests and discuss your health history with your nurse. You will be informed on what to bring with you the day of your surgery. Pack comfortable loose fitting clothes for therapy and make sure to use this time to ask any questions that you may still be unclear about. Studies show that connecting with peers helps improve patient outcomes and attitudes! There are plenty of resources and peer groups both online and offline so if possible, meet with someone who has experienced an amputation and is fully rehabilitated enjoying everyday activities again.

 

What to Expect After Surgery?

Your length of stay in the hospital varies depending on the nature of the amputation, however, patients are usually released from acute care between 3-10 days post-op.  During your time in post-op, you and your care team will be focused on promoting optimal wound healing. Your physical or occupational therapist will start on functional mobility exercises to help decrease swelling and prevent blood clots. You'll learn simple exercises and stretches to keep your body and leg strong while improving your range of motion in the affected limb. Always keep in mind that properly following the instructions provided by your rehab team can prevent infection and aid in the future use of a prosthesis. Considering when the surgical incision has healed, how your swelling is doing and your physical condition, a prosthetic fitting can take place between 2-6 months after surgery. However, this isn't always the case, as your health care system and region can be some of a few of the factors that affect how quickly you are fitted with a prosthesis.

Everyone heals at their own pace, nevertheless, regaining mobility is the ultimate goal of everyone on your team. The loss of a limb is a huge event and recovery is a process that every amputee goes through at a vastly varied pace. Your emotional and mental health at this time is just as important as your physical rehabilitation. There are a plethora of healthcare providers, peer visitors, and support groups available that can aid in making this recovery process easier.

We will continue to put out resources for recent amputees on our blog, in the meantime check out these websites for more information. 

www.amputee-coalition.org 

https://www.physio-pedia.com/Amputee_Resources