General Information

DEFINITION--Removal of a limb or appendage.

BODY PARTS INVOLVED--Arms; legs; hands; feet; fingers; or toes.

REASONS FOR SURGERY--

Performed when blood circulation to a part of the body is irreversibly interrupted, usually caused by one of the following:

• Injury to blood vessels that cannot be repaired or reconstructed. > Hardening of the arteries. > Impaired blood circulation as a complication of diabetes mellitus. > Buerger's disease. > Raynaud's phenomena. > Severe infection with gangrene. > Obstructions in the arteries. > Severe frostbite.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Smoking; obesity; stress.
• Poor nutrition.
• Excess alcohol consumption.
• Newborns and infants.
• Coronary artery disease.
• Disease that increases coagulability of blood.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; narcotics; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES--General surgeon or orthopedic surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of part to be amputated.
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made around the part to be amputated.
• Tissue, muscles, blood vessels, nerves and bone are severed.
• The bone is filed smooth, and the bone end is covered with connective tissue. Frequently tubes are left in the wound to allow drainage.
• Muscles are closed with large sutures. The skin is closed with fine sutures, which are left in place for 3 to 4 weeks after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding, surgical-wound infection or muscle contractures (shortening of muscles).
• Feelings that the limb is still there and hurts ("phantom limb").
• Pulmonary embolism.

AVERAGE HOSPITAL STAY--2 to 7 days.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 6 weeks for recovery from surgery. A physical rehabilitation program may be frustrating, but it will lead to improved self-esteem and independence.

Postoperative Care

> Use an electric heating pad, a heat lamp or a warm compress to relieve surgical--

wound pain, if your doctor approves.

• Bathe and shower as usual. You may wash the surgical wound gently with mild unscented soap.

> You may use non--prescription drugs, such as acetaminophen, for minor pain.

> To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 3 months after surgery. > Resume driving 5 weeks after returning home, if able.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing.

Call Your Doctor If

> Pain, swelling, redness, drainage or bleeding increases in the surgical area.