What Is Amputation? In Which Cases Is It Performed?
Amputation is the surgical removal of all or part of a body part or extremity. This type of surgery can be performed on various areas, including above-knee amputation, below-knee amputation, arm amputation, hand amputation, finger amputation, and foot amputation. Amputation refers to the loss or removal of body parts such as fingers, toes, hands, feet, arms, or legs. This experience can fundamentally change a person's life by affecting mobility, work capacity, social interactions, and level of independence. Continued pain sensation after this surgery, the phantom limb phenomenon, or emotional trauma may prolong the healing process and make it more difficult.
After amputation, both the physical and emotional recovery of the person are of great importance. In this process, physical rehabilitation and psychological support may be needed in cooperation with the healthcare team. Prosthetics specialists can support the independence of amputees by providing custom prostheses and assistive devices. To replace the limb or extremity lost through amputation and to regain functionality in daily life, physical therapy and rehabilitation methods are used. In this process, the aims are to increase muscle strength, improve mobility, and learn to use a prosthesis. Amputation is a condition that can have profound effects on a person's life. However, thanks to modern medicine and rehabilitation methods, it is possible to improve the quality of life of amputees and return to a functional life. With the support of a caring healthcare team and loved ones, amputees can progress toward developing a new lifestyle and adapting successfully.
In Which Cases Is Amputation Performed?
Amputation may be performed in the following cases:
Traumatic injuries: Serious traumatic injuries resulting from events such as motor vehicle accidents, work accidents, and war injuries can lead to amputation. It is one of the most common causes of amputation. It accounts for approximately 45% of all amputations performed.
Tissue damage: Conditions such as crush injuries, cuts, tissue tears, or severe burns may cause body parts to be damaged beyond recovery and require amputation.
Infection and disease: Non-healing wounds, infections, or diseases may progress to a level that endangers other body parts and make amputation necessary.
Interruption of blood flow: Insufficient blood flow to the limbs, caused by trauma or disease, can lead to tissue death in the limbs and may require amputation.
Cancer: Cancerous tumors in the limbs may require removal of the affected limb.
Other health problems: Complications of diabetes, peripheral vascular disease (narrowing of the arteries supplying the legs and feet), neuroma or thickening of nerve tissue, and severe burns may also be among the causes of amputation.
Amputation is a surgical intervention that can be applied in such cases. Amputation is a serious decision and a last resort. Your doctor will evaluate every possibility before making this decision. However, if there is no way to save the limb and it has begun to damage your other tissues, protecting your general health is the physician's first duty at that point. The rehabilitation process and prosthesis use after amputation can improve the individual's quality of life and help them regain functionality.
Amputation Surgery?
Amputation surgery may vary depending on which part of the body is affected, the cause of the amputation, and the degree of damage to the bone or tissue. When limbs function, skin tissue works together with the nerves responsible for fine motor function, muscles, blood vessels, and bones. Performing the procedure while protecting and stabilizing all of these tissues is not an easy task. For this reason, above all, it is advisable to make sure the procedure is performed by a physician who is an expert in the field and in a fully equipped hospital.
Amputation is generally performed in stages. This is because, when tissue damage, chronic pain, scarring, or other health problems are observed, an additional procedure called a revision may be required. The amputation procedure may be performed urgently due to an unexpected situation, or it may be performed as a planned procedure. Before planned amputations, you will be informed about the process before and after surgery through a series of consultations with your surgeon, and you can ask any questions you have. It may be easier to have a supporter with you during this process. Having a relative or friend with you can provide support. A preparation process may be needed before amputation. This process includes options such as medical examination or psychological evaluation. After the necessary evaluations are completed, the patient's health condition is assessed and postoperative rehabilitation is planned. It is important to remember that amputation is a process specific to each individual, and your surgeon will determine the method most suitable for your situation.
What are the types of amputation?
Amputation is divided into 2 types according to how it is performed. These are open amputation and closed amputation.
Open Amputation
If an open dressing is applied after the amputation procedure without closing the skin tissue, this method is called open amputation. Thus, if an infection is present, the tissue can continue to be cleaned because it has not yet been closed. This method is mostly preferred for patients who need amputation due to infection and vascular disease. In addition, it can be preferred when the skin tissue is not sufficient to cover the wound.
Closed Amputation
Another type of amputation is closed amputation. In this type, there is enough skin tissue to cover the area where the limb was cut. After the limb is surgically removed, the tissues are joined and no open wound is left. This method is mostly applied to patients with a low risk of infection.
The second type, closed amputation, is performed when there is enough skin tissue in the amputated area to close the wound. After the limb is cut by surgical method, the tissues and skin at the surgical wound are closed and the amputation is completed without leaving an open wound.
How Is the Decision for Amputation Made?
Deciding on amputation is a process that requires many evaluations and discussions. Making the decision to amputate is not easy for a doctor either. For this reason, the decision is made by a team. The patient's condition and all available options are evaluated in detail. After all options have been reviewed, a decision is made and the patient is informed about it. Once the decision to amputate is made, the surgery is performed as soon as possible. However, if it is decided not to amputate, this decision is explained to the patient in detail. The most suitable treatment plan for the patient's condition is determined, and alternative options are evaluated. In this process, it is important for the patient and the surgical team to decide together and to work in close cooperation through communication.
How long does amputation surgery take?
It is difficult to give an exact duration for amputation surgery. It may vary depending on the size of the area to be cut, the method to be applied (open amputation or closed amputation), or your doctor's expertise. Amputation surgery may take an average of 45 to 90 minutes.
What does the patient's process look like after amputation?
After surgery, you will be taken to the post-anesthesia care unit and kept under observation. Your recovery process may vary depending on the area where the procedure was performed or the anesthesia used. While under observation, blood flow and sensation in the operated area will be checked. If your vital functions such as blood pressure, pulse, and breathing are stable, you will not need to stay in this room any longer and will be moved to a regular hospital room. In this room, your pain management and dressing care will be provided. Physical therapy begins quickly after amputation surgery. Depending on the amputation surgery you underwent, you will have a treatment plan arranged specifically for you. For example, if you need to use a wheelchair after amputation, your treatment plan may include exercises such as getting up from a wheelchair. In addition, companies that design prosthetic devices will contact you after surgery and inform you about the matter. Depending on your healing process, you may begin using a prosthetic limb within 2 weeks.
After you are discharged and return to your own home, you may feel more emotional than you did in the hospital and may experience the pain of the lost limb more intensely. In addition, you may experience a condition called phantom pain during this period. It is difficult to cope with all of this alone. Therefore, getting support from a psychologist throughout the process can make it easier for you. Before discharge, your doctor will inform you about home care. During this period, various care tasks such as dressing changes and medication can be done by yourself or a relative, or you can benefit from home health services. Unless your doctor gives you instructions to the contrary, you can continue your normal diet.
What should be considered after amputation surgery?
If you experience any of the following symptoms, contact your doctor immediately:
Fever and chills
Redness, swelling, bleeding, or a discharge you cannot make sense of at the amputation site
Increasing pain in the amputation area
Numbness or tingling in the remaining arm or leg
How long does recovery take after amputation?
The healing process of the wound after amputation may generally take 3 to 4 weeks. However, healing of the deeper tissues under the skin requires a longer period. This period may reach an average of 12 to 18 months. Early-stage wound care after surgery and care applied at home are steps of great importance for healing the soft tissue inside and reducing the risk of infection. Regular dressings, appropriate hygiene practices, and following the doctor's instructions positively affect the healing process. The patient should attend regular check-up appointments with their doctor and report any problem immediately. Patience and support play an important role in the healing process.
