- Is the total or partial surgical removal of an extremity or digit.
- It is done in cases of inadequate tissue perfusion not responsive to other treatments, such as with diabetes mellitus or other peripheral vascular diseases.
- The extent of amputation is based on the level of maximal viable tissue available for wound healing.
Etiology and Pathophysiology
- Refers to the removal of a body part as a result of a trauma or surgical intervention.
- Necessitated by: malignant tumor, trauma, and acute arterial insufficiency.
Signs and Symptoms
- Limited motion
- Local swelling
- Weight loss
- Elevated serum alkaline phosphatase
- Below the knee amputation (BKA)
- Common in peripheral vascular disease.
- Facilitates successful adaptation to prosthesis because of retained knee function.
- Necessitated by trauma or extensive disease.
- Usually necessitated by severe trauma, malignant tumors, or congenital malformation.
- Neurovascular status of involved extremity.
- History to determine causative factors and health problems that can compromise recovery.
- Client’s understanding of the extent of the surgery.
- Client’s coping status.
- Client’s support system.
- Body image disturbance
- Diversional activity deficit
- Risk for injury
- Impaired physical mobility
- Self-care deficit
- Risk for skin integrity
- Situation low self-esteem
- Provide care preoperatively by initiating exercise to strengthen muscles of extremities in preparation for crutch walking.
- Encourage coughing and deep breathing exercises.
- Monitor vital signs and stump dressing for signs of hemorrhage.
- Elevate stump for 12 to 24 hours to decrease edema.
- Maintain elastic bandage to shrink and shape stump in preparation for prosthesis.
- When wound is healed, wash stump daily, avoiding the use of oils which may cause maceration.
- Apply pressure to the end of the stump with progressively firmer surfaces to toughen stump.
- Encourage the client to move the stump.
- Place the client with a lower extremity amputation in a prone position twice daily to stretch the flexor muscles and prevent hip flexion contractures.
- Teach the client about phantom limb sensation.
- Support the client through fitting, application, and utilization of prosthesis.
- Encourage family to participate in care.
- Allow the client to express emotional reactions.