Limb Amputation

Amputation is the surgical removal of all or part of a limb or extremity such as an arm, leg, foot,
hand, toe, or finger.

About 1.8 million Americans are living with amputations. Amputation of the leg -- either above or
below the knee -- is the most common amputation surgery.
Reasons for Amputation

There are many reasons an amputation may be necessary. The most common is poor circulation
because of damage or narrowing of the arteries, called peripheral arterial disease. Without
adequate blood flow, the body's cells cannot get oxygen and nutrients they need from the
bloodstream. As a result, the affected tissue begins to die and infection may set in.
Other causes for amputation may include:
 Severe injury (from a vehicle accident or serious burn, for example)

 Cancerous tumor in the bone or muscle of the limb
 Serious infection that does not get better with antibiotics or other treatment
 Thickening of nerve tissue, called a neuroma
 Frostbite
Surgical Interventions
1. Below the knee amputation (BKA)

 Common in peripheral vascular disease.
 Facilitates successful adaptation to prosthesis because of retained knee function.
Above the knee amputation (AKA)
 Necessitated by trauma or extensive disease.
Upper extremity amputation
 Usually necessitated by severe trauma, malignant tumors, or congenital malformation.
 Most postoperative nursing care priorities are the same as for any surgical patient:
assessing and maintaining the patient's airway, breathing, and circulation; monitoring
vital signs; managing pain; taking steps to prevent respiratory complications and venous
thromboembolism; and watching for signs and symptoms of hemorrhage.
Assessment:
1. Neurovascular status of involved extremity.
2. History to determine causative factors and health problems that can compromise recovery.
3. Client’s understanding of the extent of the surgery.
4. Client’s coping status.
5. Client’s support system.
Possible Nursing Diagnosis:
 Body image disturbance

 Constipation
 Diversional activity deficit
 Fear
 Risk for injury
 Impaired physical mobility
 Self-care deficit
 Risk for skin integrity
 Situation low self-esteem
Nursing Care:
 Provide care preoperatively by initiating exercise to strengthen muscles of extremities in

preparation for crutch walking. Encourage coughing and deep breathing exercises.
 After surgery, the patient will have a soft dressing or a rigid dressing made of fiberglass
or plaster. Assess the surgical dressing for integrity and drainage. Elevate the stump for
the first 24 to 48 hours to decrease edema.
 Move and turn the patient gently and slowly to prevent severe muscle spasms. Reposition
the patient every 2 hours, turning the patient from side to side and prone, if possible.
Lying prone helps reduce hip flexion contractures. Avoid placing pillows between the
patient's legs or under the back.
 Unwrap the stump dressing every 4 to 6 hours for the first 2 days postoperatively as
prescribed and then at least once daily. Assess the stump for signs and symptoms of
infection and skin irritation or breakdown. Assess the color, temperature, and most
proximal pulse on the stump before rewrapping it, comparing findings to the contralateral
extremity. Maintain elastic bandage to shrink and shape stump in preparation for
prosthesis
 Before rewrapping the stump, provide periwound skin care as ordered, but avoid lotion.
Wrap the stump when it's elevated to prevent edema and vascular stasis. Follow your
facility's policy for replacing the bandage, such as every 2 to 4 days or sooner if it
becomes soiled.
 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.
 Help the patient perform range-of-motion and muscle-strengthening exercises. Encourage

the patient to push the residual limb into a soft pillow, then into a firmer pillow, and
finally against a hard surface to prepare for prosthesis fitting and to reduce the incidence
of phantom limb pain and sensation.
 Encourage the patient to eat a well-balanced diet. Provide emotional support and patient
teaching to help your patient deal with altered body image and lifestyle changes. Help
with the grieving process. Support the client through fitting, application, and utilization
of prosthesis.
 Encourage family to participate in care. Allow the client to express emotional reactions.
Caring of Patients undergone Limb Amputation
Submitted by:
Garcia, Micaella P.
Group, Year and Section:
Group 2, NR-43
Submitted to:
Prof. Mark Jheran Alvarez, RN, MAN

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Amputation is the surgical removal of all or part of a limb or extremity such as an arm, leg, foot,

hand, toe, or finger.

Reasons for Amputation

 Severe injury (from a vehicle accident or serious burn, for example)

1. Below the knee amputation (BKA)

Possible Nursing Diagnosis:

 Body image disturbance

 Provide care preoperatively by initiating exercise to strengthen muscles of extremities in

 Help the patient perform range-of-motion and muscle-strengthening exercises. Encourage

Caring of Patients undergone Limb Amputation

Group, Year and Section:

Prof. Mark Jheran Alvarez, RN, MAN

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