(Surgical Removal of an Extremity/Limb)
What is amputation?
Amputation is a surgical procedure that involves removal of an extremity / limb (leg or arm) or a part of a limb (such as a toe, finger, foot, or hand), usually as a result of injury, disease, infection, or surgery (to remove tumors from bones and muscles). Amputation of the leg (above and below-knee) is the most common type of amputation procedure performed.
Why are amputations done?
The most common reason for an amputation is poor circulation. The lack of circulation is caused by narrowing of or damage to the arteries (also known as peripheral arterial disease). Peripheral arterial disease (PAD), which most frequently occurs in persons between the ages of 50 to 75 years, usually results from diabetes or atherosclerosis (a buildup of plaque inside the artery wall). When the blood vessels become damaged and the blood flow is impaired to the extremities, the tissue starts to die and may become infected.
Advanced peripheral arterial disease is generally treated through other methods. However, amputation may be necessary for some individuals. Peripheral vascular disease with or without diabetes is the most common indication for amputation. PAD-related causes account for up to 90 percent of all amputations.
Other indications for amputation include a traumatic injury, such as severe burn or accident, or a cancerous tumor in a limb. Trauma is the leading indication for amputations in younger persons.
Amputation may also be performed for acute or chronic infections that do not respond to antibiotics or surgical debridement (removal of dead or damaged tissue). In some cases, an amputation procedure may be performed due to neuroma (a thickening of nerve tissue that may develop in various parts of the body), frostbite, or arterial blockage.
There may be other reasons for your doctor to recommend an amputation.
What are the risks of the procedure?
Patients with diabetes, heart disease, or infection have a higher risk of complications from amputation than persons without these conditions. Serious traumatic injury increases the risk of complications. In addition, persons receiving above-knee amputations are more likely to be in poor health; therefore, these surgeries can be riskier than below-knee amputations.
As with any surgical procedure, complications can occur. Some possible complications that can occur specifically from an amputation procedure include a joint deformity, a hematoma (a bruised area with blood that collects underneath the skin), infection, wound opening, or necrosis (death of the skin flaps).
Deep vein thrombosis and pulmonary embolism pose a risk after an amputation primarily due to prolonged immobilization after surgery.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
Before the procedure
Your doctor will explain the amputation procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
You will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if something is not clear.
In addition to taking a complete medical history, your doctor may perform a complete physical examination to ensure you are in good health before you undergo the procedure. You may undergo blood tests or other diagnostic tests.
You will be asked to fast for eight hours before the procedure, generally after midnight.
If you are pregnant or suspect that you may be pregnant, you should notify your doctor.
Notify your doctor if you are sensitive to or are allergic to any medications, latex, tape, or anesthetic agents (local and general).
Notify your physician of all medications (prescription and over-the-counter) and herbal supplements that you are taking.
Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
You may be measured for an artificial limb prior to the procedure.
You may receive a sedative prior to the procedure to help you relax.
Based on your medical condition, your doctor may request other specific preparation.