Amputation

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