Strong Heart and Vascular Center

Division of Vascular Surgery

Amputation

Diagnosis

You have a problem necessitating amputation of a limb. This is typically due to death of tissue (gangrene) or a problem that means you cannot use the limb, even if other techniques are used. Occasionally amputation is recommended even if the limb is not dead when procedures needed to save it are considered too dangerous.

What to Expect During Your Visit

We will discuss all possible options and typically test your circulation, unless this has been done already.

Treatment Options

Amputation is recommended only when no other options exist–either restoration of blood flow or use of the limb cannot be performed, or it is too dangerous. We exhaust all other options before recommending surgery, and you should have discussed all possibilities at length with your surgeon before agreeing to amputation.

Surgery

Amputation itself is a short procedure that can be performed under spinal or general anesthesia, but patients requiring this surgery are typically relatively ill. Your surgeon will discuss specific risks in your case. Amputation can be performed above or below the knee. The advantage of keeping the knee joint is improved rehabilitation using a prosthetic leg, but healing is less certain. Healing is better above the knee, but rehabilitation harder. This recommendation is individualized and your surgeon will discuss this issue with you.

After the procedure

Postoperative pain is usually easily controlled and patients are generally quite comfortable. You will usually be in the hospital for about 2 days. During this time we will work with you and your family on strategies for healing and rehabilitation, and the physical therapists will start to help you get out of bed the day after surgery. Depending on your age, health, and support system, you can be discharged to home with outpatient rehabilitation or to inpatient rehabilitation at Strong or another facility. Dressing and wound care will vary according to discharge plans, but in general dressings will be removed '36-48 hours after the operation, after which you can shower or wash the leg. You should not, however, soak the leg until cleared by the surgeon. If staples or sutures are present they will be removed a few weeks following the procedure. If you have a cast, different instructions will be given.

You will see your surgeon 2-4 weeks after surgery. If prosthetic fitting is contemplated, a referral to a prosthetist will be made at about this time, who will instruct you as to the process to follow.