Amputation
What it is amputation? Defined as the surgical removal of all or part of
a limb or extremity such as an arm, leg, foot, hand, toe, or finger.
Why amputate? Most common reason for amputation is
poor circulation because of damage or peripheral arterial disease.
Other reasons include:- Trauma- Cancer- Frostbite- Serious infection- Congenital defects
Preoperative Care Nursing responsibilities specific to patient undergoing
amputation include:- A total physical examination with particular attention to the
neurologic, cardiovascular, and integumentary systems- Utilizing functional assessment to determine how
amputation will affect daily living - Performing psychological evaluation to determine how
procedure will be tolerated- Administering antibiotics before surgery - Tending to emotional needs of patient regarding anxiety
and grieving from loss of body part Arrangements to begin construction of prosthetic device
are often made before surgery
Surgery Objective when amputating is
to remove all damaged tissue while leaving as much healthy tissue as possible
During procedure, surgeon will:- Remove the diseased tissue
and any crushed bone- Smooth uneven areas of bone- Seal off blood vessels and
nerves- Cut and shape muscles so
that the ends of the limb, or stump, will be able to have a prosthesis
Possible Complications Problems that often occur include:
- Hematoma and hemorrhage- Necrosis- Wound dehiscence- Gangrene- Edema- Contracture- Pain - Infection
Postoperative Care Typically require hospital
stay of 5 to 14 days or more Generally the same as most
surgeries: take vital signs, monitor for complications, wound assessment, pain assessment, etc.
Physical therapy often begins soon after surgery with gentle stretching exercises.
Practice with the prosthesis may begin as soon as 10 to 14 days after surgery
Discharge Teaching Discharge teachings
include:- What to expect at
home: use of walker, wheelchair, and prosthesis
- Self care: compliance with medications and food regimen, emotional counseling, and assistance measures to take at home
Discharge Teaching (cont’d)- Wound Care:
Refraining from using limb, putting weight on it, or rubbing it
Not driving Keeping wound clean and dry Frequently checking for redness or presence
of dirt Keeping amputation site inside prosthetic
stocking
Discharge Teaching (cont’d) - Contact physician if:
Wound looks redder and is warm to the touch Swelling or bulging around wound New drainage New openings in wound Temperature above 101.4 more than once Skin around wound is turning dark Pain keeps getting worse and medications not
effective Wound has gotten larger A foul smell coming from the wound
Conclusion Patients with amputation may go
through grieving process for long periods of time
Pain MUST be acknowledged Hope has to be kept alive
BibilographyA.D.A.M. (2012, November 11). Amputation - traumatic. Retrieved on December 3, 2012
from http://www.nlm.nih.gov/medlineplus/ency/article/000006.htm
Chatterjee, R. (2010, March 05). Definition of amputation. Retrieved on December 3, 2012 from
http://www.webmd.com/a-to-z-guides/definition-amputation
Clements, I. (2011). How Amputation Works. Retrieved on December 3, 2012 from
http://science.howstuffworks.com/life/human-biology/amputation6.htm
Linton, A. (2012). Introduction to Medical-Surgical Nursing. (5th ed.). Chapter 43: pgs. 979-
993. St. Louis: Elsevier Inc.
NHS Choices. (2010, Novemeber 08). How amputation is performed. Retrieved on December
3, 2012 from http://www.nhs.uk/Conditions/ Amputation/Pages/How-it-is-performed.aspx