Amputations can be the result of sepsis or be a cause of sepsis.
Your blood plays 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.
As of 2020, physicians are finding that many people who contract the novel coronavirus that causes COVID-19, develop blood clots. Some of these clots are causing strokes or heart attacks, but others are causing blockages that cause enough damage to require amputations.
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 body’s 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, the surgeon may be able to remove just enough to stop the spread. However, if the damage is extensive, an amputation may be needed.
There are many causes for amputations, from traumatic injury and 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. There are, on average, about 38 amputations a day due to sepsis and about 1% of sepsis survivors undergo one or more surgical amputations of a limb or digit as a result of sepsis. This 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 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.
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.
The length of time to recover from an amputation depends on many things:
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 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.
The move from amputation to prosthetics can be a fast one. If the patient is strong enough and is healing well, a temporary leg prosthetic could be tried 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.
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.
Information regarding sepsis and amputations is also available as a Sepsis Information Guide, which is a downloadable format for easier printing.
Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.
Updated March 3, 2023.
An undiagnosed UTI became septic resulting in the amputation of both feet and arms plus a collapsed urethra and the loss of my colon. (Sepsis and Urinary Tract Infections, Sepsis and Amputations) I had no standard UTI symptoms, only slight lower back pain over my kidneys, which I blamed on lifting boxes. Pain got worse. Husband said I should go to urgent care, but like many people I said it would get better on it’s own. Lesson learned: It’s better to go to the doctor and find out you didn’t need to go than to not go and potentially end ... Read Full Story
Submit Your StoryView More Stories
Beauden born a healthy boy, fell off his bike when he was 3 on the first day of our family vacation in San Diego in October of 2020. He scraped his knee and 48 hours later was admitted to a Pediatric ICU in San Diego where he stayed for 2 months, then another floor for 2 more weeks. Beauden contracted staph which was MSSA but acted like MRSA and went into septic shock. (Sepsis and Antimicrobial Resistance (AMR)/Antibiotic Resistance) He required a bilateral leg amputations and lost a couple fingers as well. (Sepsis and Amputations) To date, he has had ... Read Full Story
Submit Your StoryView More Stories
I’m Sue from Chichester, UK. In 2017, I went to the dentist and he nicked my gum which got infected, and I went into the worst abscess. (Sepsis and Dental Health) I had the highest temperature I’ve ever had in my life, and at about 9pm that night my husband came to check on me before going to bed, I was all blue, grey and hardly breathing. By that night I was rushed to hospital, I didn’t know anything about it. Turns out I had sepsis. I had all my limbs amputated, lost my nose, and all my lips, four ... Read Full Story
Submit Your StoryView More Stories
Ryan was a active, happy one year old perfect little boy. A month after his birthday Ryan woke up with a snotty nose. Throughout the day he still seemed his happy self. By that afternoon he was having slight temperatures and was starting to not be himself, he was very clingy and wimping, quiet dazed and also wouldn’t weight bear which he had been walking for a few months. We took him to the hospital to be released with that he probably had a virus and just teething. The next morning we noticed Ryan still wasn’t improving so went back ... Read Full Story
Submit Your StoryView More Stories
I went septic from walking pneumonia on Dec 18, 2004. (Sepsis and Pneumonia) I had all my toes amputated after they turned black on Jan 9. 2005. (Sepsis and Amputations) The heel of my right foot also was black and there was a skin graft performed on it with a piece of skin cut from my thigh. My purpose of submitting this is hopes of finding other survivors like me to help me understand how to walk again. I can walk but am in severe pain and have developed large blisters and callous. Over the last 16 years I have ... Read Full Story
Submit Your StoryView More StoriesAmputations can be the result of sepsis or be a cause of sepsis.
Your blood plays many roles. Its most important is that it carries 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.
