Presented By: Marieann McGhee AMPUTATION Presented By: Marieann McGhee

Pathophysiology The removal of a body extremity by trauma or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases it may be used as a preventative surgery for such problems. In some islamic countries amputation of the hands and feet is sometimes used as a form of punishment for criminals Some cultures and religions view amputations as ritual accomplishments.

Statistics 82% of amputations are due to vascular disease 22% are due to trauma 4% are due to congenital defects 4% are because of tumors

What Causes The Need For Amputation? Diseases such as blood vessels (peripheral vascular disease), diabetes, blood clots, or osteomyelitis. Injuries to the arms, legs, fingers etc. (75% of upper extremity amputations are related to trauma) Surgery to remove tumors form bones and muscles

Diagnostic Tests A CBC is done to determine any blood dyscrasias, like anemia, bleeding tendencies that would influence the outcome and increase complications both during and after surgery EKG’s to determine any cardiac dysrhythmias

What Happens During Amputation? Your doctor must remove the diseased limb but preserve as much healthy skin, blood vessels, and nerve tissue as possible. If the surgeon removes too little tissue your wound will not heal because unhealthy tissue remains and circulation is impaired If you have a traumatic injury the surgeon will remove the crushed bone and other damaged tissue. Once surgery is complete the team may place a stocking over your stump to hold drainage tubes and wound dressing in place. The limb may be placed in traction or a splint just depending on the situation.

OUCH!!!!!

After Amputation Loss of a limb produces a permanent disability that can impact a patients self image, self care, and mobility. The patients success depends on many variables such as type and level of amputation, overall patient health, and family support.

Phantom Pain Phantom limb pain occurs in 50-80% of amputees The feeling or sensation that the limb is still attached causing burning, tingling, itching, and pain. There are no meds specific for phantom pain. The doctor may try a combination of pain medication, antidepressants, and counseling.

Rehab Programs Include Treatments to help wound healing and stump care Activities to improve motor skills, ADL’s, and help the patient reach maximum independence. Exercises to promote muscle strength Pain management Use of assistive devices Nutritional counseling Patient and family education

Nursing interventions Allow pt to express feelings of mutilation, grief, and anger Encourage patient to help with dressing changes Turn and position patient Teach adduction and extension exercises Arrange for social service consultation Family and patient education