When a surgeon performs an amputation, he or she removes a limb, or part of a limb, that is no longer useful and may be causing great pain, or threatens one’s health because of extensive infection. Most commonly, a surgeon removes a toe, foot, leg, or arm. Physicians consider amputation a last resort. The most common reason one may need an amputation is if one has peripheral arterial disease (PAD) due to atherosclerosis (hardening of the arteries).
In PAD, the blood vessels in the limbs become damaged because of hardening of the arteries or diabetes. The body’s cells depend on a constant supply of oxygen and nutrients from the blood. If blood vessels are unable to deliver blood and oxygen to the fingers or toes, the cells and tissues die and are vulnerable to infection. Extensive tissue death may require amputation. Traumatic injury, such as a car accident or a severe burn, can destroy blood vessels and cause tissue death, resulting in amputation. A physician may recommend amputation if one has cancerous tumors in a limb.
After surgery, the patient may stay in the hospital for approximately 5 to 14 days, depending upon the particular situation. If the condition permits, ideally, one will receive physical therapy soon after surgery. Again, depending upon the particular situation, the patient may also begin to practice with the prosthesis (artificial limb) as early as 10 to 14 days after surgery, but this depends upon one’s comfort and wound healing progress. One may have complications following any surgical procedure. Complications that occur specifically from amputation include a joint deformity called contracture, a severe bruise called a hematoma, death of the skin flaps (necrosis), wound opening, or infection. A prosthesis can irritate the stump, which requires adjusting the prosthesis and occasionally stump revision. Generally, the surgeon can treat all of these complications.
An amputee can also experience phantom limb pain, which is pain appearing to come from where an amputated limb used to be. The sensation can be that of excruciating pain or burning.
Phantom limb pain can be chronic and intractable. Scientists believe that following amputation nerve cells “rewire” themselves and continue to receive messages, resulting in a remapping of the brain circuitry. Treatments for phantom limb pain may include analgesics, anticonvulsants, and other types of drugs; nerve blocks; electrical stimulation, psychological counseling, biofeedback, hypnosis and acupuncture. In rare instances surgery may be considered.
In the past prostheses had no mobility. They were replaced with models that had joints and could be bent. Today, some prostheses can be controlled by the nerves and impulses controlling the missing limb. If the microvolts of electricity that are sent by the brain are amplified, a motor in the prosthesis can move the artificial limb.
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