2. DEFINITION
Amputation is the removal of a body part,
usually an extremity.
Amputation of a lower extremity is often done in
the following cases.
Diabetes mellitus
Fulminating gas gangrene
Trauma (crushing injuries, burns, frostbite, electrical
burns)
Congenital deformities
Chronic osteomyelitis, or malignant tumor
3. Amputation is used to relieve symptoms,
improve function, and save or improve the
patient’s quality of life.
4. TYPE OF AMPUTATION
OPEN AMPUTATION: Major indication for open
amputation is infection. Surgeon doesn’t close the stump with
skin flap immediately. But leaves it open allowing the wound to
drain. Once the infection is completely eradicated the client
undergo stump closure.
CLOSE & FLAP AMPUTATION: Surgeon Closes
or cover the stump with flap of the skin, sutured over the end of
the flap. This type of amputation is done when there is no risk of
infection or no need of open drainage.
5. LEVELS OF AMPUTATION
Amputation is performed at the most distal
point that will heal successfully.
The site of amputation is determined by two
factors:
The objective of surgery is to conserve as
much extremity length as possible.
Preservation of knee and elbow joints is
desired.
• Circulation in the part
• Functional usefulness
8. MEDICAL MANAGEMENT
The objective of treatment is to achieve healing of the amputation
wound.
Healing is enhanced by gentle handling of the residual limb, control of
residual limb edema through rigid or soft compression dressings, and
use of aseptic technique in wound care to avoid infection.
A closed rigid cast dressing is frequently used to provide uniform
compression, to support soft tissues, to control pain, and to prevent joint
contractures.
Immediately after surgery, a sterilized residual limb sock is applied to the
residual limb.
Felt pads are placed over pressure-sensitive areas.
The residual limb is wrapped with elastic plaster-of-paris bandages while
firm, even pressure is maintained.
9. NURSING MANAGEMENT
Assess the general condition of the patient.
Check vital signs & ECG.
Preparation of the skin as per hospital procedure.
Encourage deep breathing & coughing exercises.
Provide psychological support.
Explain procedure & need for the amputation.
Provide pre operative teaching.
Take written consent before starting the procedure.
11. REHABILITATION
The amputation is the result of an injury, the
patient needs psychological support
in accepting the sudden change in body image
in dealing with the stresses of hospitalization,
long-term rehabilitation, and modification of
lifestyle.
Patients who undergo amputation need
support as they grieve the loss, and they
need time to work through their feelings
about their permanent loss and change in
12. The multidisciplinary rehabilitation team (patient,
nurse, physician, social worker, psychologist,
prosthetist, vocational rehabilitation worker)
helps the patient achieve the highest possible
level of function and participation in life
activities.
13. WRAPPING THE RESIDUAL LEG AFTER AN ABOVE-KNEE AMPUTATION. ELASTIC BANDAGING
MINIMIZES EDEMA AND SHAPES THE STUMP IN A FIRM CONICAL FORM TO FIT A PROSTHESIS.
14. WRAPPING THE RESIDUAL ARM AFTER AN ABOVE-ELBOW AMPUTATION. PASSING THE BANDAGE
WRAP ACROSS THE BACK AND SHOULDERS MAY AUGMENT SECURITY.
