According to the National Limb Loss Center (NLLC) in the United States, there are approximately 1.7 million people in the country who have some sort of amputation. There are many causes for amputations, from traumatic injury illnesses, such as sepsis.
When the decision is made to perform an amputation, the surgeon must decide at what level it needs to be done. The decision is based on ensuring that enough tissue is removed to make certain that all damaged tissue is gone, while trying to preserve the patient’s independence and mobility as much as possible. It is important to understand that sometimes after the surgery has begun, the surgeon may have to do a larger amputation than originally planned. Much of the procedure depends on the condition of the muscles and the skin and sometimes this isn’t obvious before the surgery.
Once the amputation is complete, the surgeon has two options: leave the site open or close it up right away. An open site, where the incision is not sewn or stapled closed, allows the doctors and nurses to monitor for and remove any infected tissue that might have been left behind. If this procedure is chosen, the surgeon will close up the flap once he or she is sure that the site is completely clean and infection-free.
After the surgery
The length of time to recover from an amputation depends on many things:
- The location of the amputation,
- The number of limbs amputated,
- The reason for the amputation,
- The medical condition of the patient following the surgery.
Ideally, patients who have had an amputation will begin physiotherapy as soon as possible. Physiotherapy may include stretching and increasing muscle strength or learning how to transfer from a bed to a chair if a leg or legs were amputated. Occupational therapists also play an important role in helping amputees learn how to use special tools or adapt their living environment as needed.
How long it takes for the limb to heal depends on many things, but the ideal healing time for the incisions is about four to eight weeks.
Pain can be a big issue for amputees. They have the pain from the amputation, but they may also experience phantom limb pain – pain coming from the limb that is no longer there. It is estimated that as many as 80 percent of amputees feel some level of phantom pain. This type of pain can be hard to manage because it is not understood. It’s not like a cut or a swelling, for example. However, that doesn’t mean you have to suffer needlessly. There are treatments that have been successful for some people, but you may have to try different approaches before you find one that works for you.
The NLLC has a good pain information fact sheet to help you learn about the types of pain, how to describe it, and how best to talk to your healthcare providers.