What is Amputation?
Amputation is the removal of a body part, such as a finger, toe, hand, foot, arm or leg. It can be a life-changing experience that affects the body’s ability to move, work, interact with others, and maintain independence. In addition, ongoing pain, phantom limb phenomena and emotional trauma can complicate recovery.
This action or operation is actually intended to control pain or disease that attacks certain parts of the body. In fact, part of the body can also be lost before birth, which is called congenital amputation. Healing, recovery, and rehabilitation from major amputations will require a multidisciplinary approach.
Why Amputation Need to Be Done?
Amputation may be necessary to prevent infection from spreading through the limb and to control pain. The most common reason for an amputation is a wound that won’t heal.
Often this is because the limb does not have enough blood flow. Amputation is done in two conditions, namely amputation due to injury and due to disease. Here is a more complete explanation.
1. Amputation due to injury
Amputation due to injury is done when someone has a severe injury such as a crush injury. Amputation may be necessary if the surgeon can no longer repair the limb.
The process of amputation caused by an accident or injury is called traumatic amputation. This process can occur due to motor vehicle accidents, accidents at work or industry, and injuries during combat. Traumatic injuries account for about 45 percent of all amputations.
Traumatic amputation may be performed if a body part has been severed or torn off in a serious accident or is seriously damaged by crushing injuries or acute burns, such that the limb cannot be saved.
2. Amputation due to disease
Amputation due to disease occurs when there is tissue damage, infection, or disease that affects a body part and is beyond repair, or could even be life-threatening if left untreated.
In addition, trauma or disease that cuts off blood flow to a part of the body for a long time can also cause tissue death that requires amputation. For example, frostbite, which can damage blood vessels in the fingers and toes, which eventually need to be removed.
The following diseases require amputation if they have damaged a limb and cannot be repaired.
- Amputations related to diabetes and vascular disease
Approximately 54 percent of all surgical amputations occur due to complications of blood vessel disease and other conditions that affect blood flow, such as diabetes and peripheral artery disease (PAD).
Chronic vascular problems can cause tissue death in the toes, feet, and legs. Of patients who undergo amputation due to complications of this disease, nearly half will die within five years of the procedure.
- Cancer-related amputations
To prevent the spread of certain types of cancer is actually quite rare to require amputation. The total cases are usually only 2 percent.
Cancers such as sarcomas can affect the bones and soft tissues of the legs. If the cancer is too large or aggressive to remove, recurs, or spreads to nerves or blood vessels, amputation may be necessary.
Advanced cancer affecting the upper leg may result in an amputation procedure called hip disarticulation, which removes the entire thigh bone (femur) from the pelvis.
- Amputation for severe infections
Severe sepsis is also called septicemia or blood poisoning. It occurs when drug-resistant bacteria overwhelm the body and spread throughout the bloodstream. Sepsis can affect blood flow and cause tissue death, especially in the toes, fingers, hands and feet. Severe sepsis can be fatal if antibiotics cannot control the infection.
One cause of sepsis is meningococcal bacteria which causes a serious form of meningitis, which is inflammation of the lining of the brain and spinal cord.
Methicillin-resistant Staphylococcus aureus (MRSA) infections can also cause a serious condition called necrotizing soft tissue infection, or fasciitis. For these and other life-threatening infections that occur in parts of the body that the patient can survive without, amputation may be necessary to save the person’s life.
When to Perform Amputation?
Amputation is the last option recommended by doctors if there is no other way out. However, there are some special considerations in making this decision, namely:
- The appearance of gangrene or dead skin tissue.
- Severe infections that do not improve even after treatment. For example, wounds on the feet of diabetics that are difficult to heal.
- Cancer is found in that part of the body, for example in the bones or muscle tissue.
- Persistent unbearable pain and severe disability resulting in inability to function.
- Serious injuries, such as severe burns, explosion injuries, or animal bite injuries.
- Frostbite or frostbite.
Amputation Diagnosis
Before performing an amputation, the doctor will perform a thorough medical examination. The goal is to check physical conditions such as the cardiovascular system (heart, blood, and blood vessels), respiratory system, and medical history of the patient.
The doctor will also check the condition and function of other healthy limbs. This examination is done because removing one limb can add burden to the remaining limbs, so it is important to take care of and ensure that the other body parts are healthy.
The patient will also likely be assessed psychologically to determine how well they are coping with the psychological and emotional impact of the amputation. The patient will also be introduced to a physiotherapist who will be involved in post-operative care.
Complications of Amputation
Like all types of surgery, amputation also carries the risk of complications. There are several factors that affect the risk of complications such as age, the type of amputation performed, and the patient’s general health.
However, in amputations that are carried out in a planned manner, the risk of developing more serious complications will be lower than amputations carried out in an emergency.
The following are complications associated with amputation:
- Heart problems such as heart attacks
- Deep vein thrombosis ( DVT)
- Slow wound healing and wound infection
- Pneumonia
In some amputations, further surgery may be necessary to avoid complications or help relieve pain.
Amputation Surgery Procedure
There are at least three stages of the amputation process, namely:
1. Preparation
Your surgeon will give you specific instructions on how to prepare for your amputation surgery. You will likely need to fast for at least six hours before surgery. Your surgeon may also prescribe medications to take the morning of your surgery.
Before surgery, you will receive anesthesia (medicine to keep you from feeling pain). Most often, doctors use general or spinal anesthesia. General anesthesia also requires you to be asleep during surgery. Spinal anesthesia numbs you from the waist down.
2. Amputation process
In an amputation, the surgeon will remove all of the diseased tissue. The team will keep as much healthy tissue intact as possible. Doctors will also plan the surgery to set the patient up for optimal function once they recover. That includes planning for the use of prosthetic limbs.
During the procedure, the surgeon will:
- Removes damaged tissue and crushed bones.
- Smoothes uneven bones.
- Clots blood vessels to prevent bleeding.
- Building muscle so that the stump (end of the leg) can be fitted with a prosthetic limb if desired.
- Place a sterile dressing (bandage) over the wound.
- The surgeon may use stitches or staples to sew the stump closed immediately. Or the surgeon may wait a few days to let the wound dry.
3. After amputation
After an amputation, the patient will need to stay in the hospital for a few days, for a week, or even two. The medical team will continue to monitor the healing process and the patient’s progress. The patient may take painkillers to relieve discomfort or antibiotics to prevent infection. The patient will also begin seeing a physical therapist within the first few days after surgery.
Many patients go to a rehabilitation facility for a while after an amputation. This is so they can learn to do things independently.
After an arm or leg amputation, a patient may be a candidate for a prosthetic limb. A prosthetic limb mimics the movement of a natural limb, but it may feel awkward to use at first. A physical therapist will teach you exercises to help you get used to your artificial limb.
Typically, the prosthetic is fitted about six to eight weeks after surgery and when the incisions are completely healed. When the patient receives the prosthesis, the patient will learn the basics of using it, including how to:
- Installing a prosthetic.
- Taking off his prosthetic.
- Walking and moving with a prosthetic leg.
- Caring for prosthetics.
Where to Perform Amputation?
Amputation surgery performed by a specialist doctor can be done in a hospital that has adequate facilities.
When to See a Doctor?
Contact a doctor immediately if you experience the conditions described above. Remember, proper and fast treatment can minimize possible complications. Make an appointment with a specialist doctor.