Surgery

 An Amputation is a surgical removal of a limb or part of a limb by cutting through the shaft of the bone.

 1) Emergency or Elective.  2)Provisional or Definitive.  3)End bearing or Non end bearing.

 Dead (or Dying)  Gangrene  Peripheral Vascular disease Atherosclerosis Embolism Severe Trauma Burns Frost bite Bone setters gangrene  Dangerous limb  Malignant tumours ▪ Osteosarcoma ▪ Marjolins ulcer ▪ Melanoma  Potentially lethal sepsis  Crush Injury  Damn Nuisance  Pain  Gross malformation  Recurrent Sepsis  Severe loss of function  Madura foot  Elephantiasis

 ANAESTHESIA : GA/Spinal  POSITION : Supine  PREINCISION : prophylactic antibiotics, exsanguinate, tourniquet, skin prep & draping.  PROCEDURE: An incision to outline a long posterior flap & a short anterior one --- combined length 1 ½ times the diameter of the leg at the level of amputation.

 General care:  Control of pain  Stump healing***  prevention of edema  prevention of infection  DVT prevention  Suture removal.  Physiotherapy:  patients taught how to use crutches & prosthesis.

 Stump dressing:  Soft dressing: gauze, cotton wool, bandage.  Xeroform

 Early  Haemorrhage  Haematoma  Infection  Late  depression  Stump ulceration  Flap necrosis  Painful scar  Phantom limb  Phantom pain  Joint stiffness  Osteomyelitis  Osteoporosis & tendency to fracture