There are many reasons an amputation may be necessary. The most common is poor circulation because of damage or narrowing of the arteries, called peripheral arterial disease.
Without adequate blood flow, the body's cells cannot get oxygen and nutrients they need from the bloodstream. As a result, the affected tissue begins to die and infection may set in.
Other causes for amputation may include:
- Severe injury (from a vehicle accident or serious burn, for example)
- Cancerous tumor in the bone or muscle of the limb
- Serious infection that does not get better with antibiotics or other treatment
- Thickening of nerve tissue, called a neuroma
More about Treatment
Amputation is the surgical removal of all or part of a limb or extremity such as an arm, leg, foot, hand, toe, or finger.
Amputation of the leg -- either above or below the knee -- is the most common amputation surgery.
The Amputation Procedure
The procedure itself may vary, depending on the limb or extremity being amputated and the patient's general health. Amputation may be done under general anesthesia (meaning the patient is asleep) or with spinal anesthesia, which numbs the body from the waist down.
When performing an amputation, the surgeon removes all damaged tissue while leaving as much healthy tissue as possible. A doctor may use several methods to determine where to cut and how much tissue to remove. These include:
- Checking for a pulse close to where the surgeon is planning to cut
- Comparing skin temperatures of the affected limb with those of a healthy limb
- Looking for areas of reddened skin
- Checking to see if the skin near the site where the surgeon is planning to cut is still sensitive to touch
During the procedure itself, the 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 stump, or end of the limb, will be able to have an artificial limb (prosthesis) attached to it
The surgeon may choose to close the wound right away by sewing the skin flaps (called a closed amputation). Or the surgeon may leave the site open for several days in case there's a need to remove additional tissue.
The surgical team then places a sterile dressing on the wound and may place a stocking over the stump to hold drainage tubes or bandages. The doctor may place the limb in traction, in which a device holds it in position, or may use a splint.
Psychological impact of amputation
The loss of a limb can have a considerable psychological impact. Many people who've had an amputation report emotions such as grief and bereavement, similar to experiencing the death of a loved one.
Coming to terms with the psychological impact of an amputation is therefore often as important as coping with the physical demands.
Having an amputation can have a considerable psychological impact for three main reasons:
you have to cope with the loss of sensation from your amputated limb.you have to cope with the loss of function from your amputated limb.your sense of body image, and other people's perception of your body image, has changed.
Negative thoughts and emotions are common after an amputation. This is particularly true in people who've had an emergency amputation because they don't have time to mentally prepare for the effects of surgery.