Sepsis and Amputations

Amputations can be the result of sepsis. Alternately, if you have an amputation, you could develop a pressure injury from a prosthetic or adaptive/assistive device and this could result in an infection that could cause sepsis.

Blood clots are a frequent cause for amputations. Your blood has many roles, one of which is to carry oxygen and nutrients to the organs and tissues throughout your body, from your brain to your smallest toe. After it provides the nutrients, the blood then collects the waste products and flows back to the heart and lungs for refreshing.

Usually, blood moves through your blood vessels (arteries, veins, capillaries) in a very fluid form, driven by your pumping heart, only clotting when the body senses it is necessary. Once in a while, the system does cause problems, and clots may develop somewhere in the body where there shouldn’t be one. When a clot forms in a blood vessel, blood can back up behind if there is a complete blockage, or can be slowed down significantly if there is still room for some blood to pass. Some common examples of health problems caused by blood clots are deep vein thrombosis (DVT) and some types of strokes.

When someone has sepsis, the clotting mechanism works overtime. As nutrients cannot get to the tissues in the fingers, hands, arms, toes, feet, and legs, the tissues begin to die and can cause gangrene. At first, the skin may look mottled, bluish purple, and then black. This dead tissue must be removed because it can cause infection to spread. If the gangrenous area is small enough, a surgeon may be able to remove just enough to stop the spread. However, if the damage is extensive, an amputation may be needed.

Sepsis, which was often called blood poisoning, is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Suggested Citation:
Sepsis Alliance. Sepsis and Amputations. 2023. https://www.sepsis.org/sepsisand/amputations/

Updated November 13, 2023.

 

More About Amputations

Surgery

There are many causes for amputations, from traumatic injury to illnesses, such as sepsis. According to the Amputee Coalition, there are approximately 2 million people in the country who have some sort of amputation and there are about 185,000 amputations each year.

Approximately 1% of sepsis survivors undergo one or more surgical amputations of a limb or digit as a result of sepsis. In 2012, there were more than 13,700 sepsis-related amputations in the U.S.  This works out to an average of 38 amputations per day. Amputations could be one limb on a patient or multiple fingers/toes and limbs.

The decision to amputate is based on making sure enough tissue is removed to ensure that all the damaged tissue is gone, but also trying to preserve your 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.

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 Surgery

The length of time to recover from an amputation depends on many things:

  • The location
  • The number of limbs amputated
  • The reason for the amputation
  • The medical condition of the patient following the surgery

Ideally, you would begin physical therapy as soon as possible. Physical therapy 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. You have the pain from the amputation, but you 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. 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 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.

Prosthetics

The move from amputation to prosthetics can be a fast one. If you are strong enough and are healing well, you could try a temporary leg prosthetic within a week or two of the amputation. It is important to get up and moving about as quickly as possible to prevent physical complications and also for mental and emotional well-being.

As with just about everything else in life, there is no one-size-fits all type of prosthetic. What works for one person who may have a similar amputation as you, may not work for you, and the other way around. The people who design the limbs and the physiotherapists use their expertise to try to find the best match for each person. Some prosthetics are purely cosmetic, others are mechanical, and yet other, newer ones, are robotic. There is a tremendous amount of research going on to help improve the lives of amputees who rely on prosthetics. Remember, it may take a good bit of trial and error to get your prosthesis to be as good as it can be for you.

Sores and Infections

When you get a new prosthetic, you must watch for signs of sores on your skin from pressure or rubbing against the device. Any wound is vulnerable to infection, so if you notice a sore forming, inform your healthcare team as quickly as possible. Your device may need alterations. Watch for signs of infection:

  • Increasing redness around the sore
  • Pus or discharge
  • Increased pain
  • Foul odor

If you notice any signs, seek medical help immediately. The quicker an infection is spotted and treated, the lesser the risk of developing sepsis.

Related Resources

Information Guide

Amputations

  • To submit this form you are required to enter your first name, last name, a valid email address and your role.

Sepsis: Nurse and Sue Amputations Taggable – PSA (0:30)

Sepsis: Nurse and Sue Amputations Taggable – PSA (0:30)

Sepsis: Nurse and Sue Amputations Taggable – PSA (0:30)

Sepsis: Nurse and Sue Amputations – PSA (0:30)

Sepsis: Nurse and Sue Amputations – PSA (0:30)

Sepsis: Nurse and Sue Amputations – PSA (0:30)

Sepsis: Michael Amputations – PSA (1:00)

Sepsis: Michael Amputations – PSA (1:00)

Sepsis: Michael Amputations – PSA (1:00)

Sepsis: Michael Amputations Taggable – PSA (0:30)

Sepsis: Michael Amputations Taggable – PSA (0:30)

Sepsis: Michael Amputations Taggable – PSA (0:30)

Sepsis: Michael Amputations – PSA (0:30)

Sepsis: Michael Amputations – PSA (0:30)

Sepsis: Michael Amputations – PSA (0:30)

Mateo Rodriguez-Limon

My son Mateo went septic a month before his 2nd birthday. He complained of a pain in his knee and after a 6 hour visit to our local hospital with no outcome we took him to to the children’s hospital. They discovered osteomyelitis in his tibia and within hours he was in full septic shock.He had contracted strep A with no clue how he was not sick and he didn’t have any open wounds. (Sepsis and Group A Streptococcus, Sepsis and Septic Shock) He spent the next 5 weeks in the PICU where they did multiple different treatments to save ... Read Full Story

Submit Your StoryView More Stories

Jamie M.

Hi, my name is Jamie M. I’m a 40-year-old mother of two elementary-aged boys and I’m a sepsis survivor. I grew up in the northeast U.S. playing field hockey and snowboarding. After a move to Florida for college, I obtained my degree and met my soulmate. We married shortly after graduation and enjoyed traveling together and working in our chosen fields. When we had our first child, I left my career to work from home as a seamstress. I ran a very successful business for many years, assisting neighbors with alterations, repairs, and custom projects. Sewing was a fantastic creative ... Read Full Story

Submit Your StoryView More Stories

Elizabeth B.

I was diagnosed with sepsis along with Strep A and toxic shock two days after giving birth to my beautiful daughter. (Sepsis and Group A Streptococcus, Sepsis and Toxic Shock Syndrome, Sepsis and Pregnancy & Childbirth) I was sent to the ER in Dallas, Texas, where I was intubated and in a medically induced coma for 8 days. I had an infection in my vagina that came from birth, resulting in five surgeries later to finally contain the infection. I was on continuous dialysis for 5 days and 3 days of intermittent dialysis. Due to the pressers I was on ... Read Full Story

Submit Your StoryView More Stories

Morgan Semko

In November 2020, during the height of COVID, I began to get sick. I was experiencing many of the same symptoms that are associated with COVID, sore throat, body aches, high fever, nausea. I was seen at a local urgent care who was aware of my underlying illnesses, and I was only tested for COVID and sent home. This process repeated 3 times over the course of two weeks. I finally ended up in the emergency room when I began to have difficulty breathing and severe pain in my neck. During my time at the emergency room an X-ray was ... Read Full Story

Submit Your StoryView More Stories

Kelsey Jones

On November 13th, 2022, I was taken to the ER by my mom, who assumed I was just dehydrated from vomiting. I was battling pneumonia once again, as I had been for the last few months on and off. I was given antibiotics just 3 days prior, but I could not keep them down. Once there, they had a hard time getting my vitals, starting an IV, and getting urine as I hadn’t urinated in nearly 24 hours. They did some bloodwork and found a WBC of 64k, my kidneys and liver were failing. From there, I was transported to ... Read Full Story

Submit Your StoryView More Stories

Other Topics

Amputations