Amputation
answers
Amputations
Definitions
 Levels of Amputations
*Goal = circulation, extremity
length & function
 Diagnostic Studies

Types of amputations

Open of Guillotine
– Required if
infection present
– Late closure

Closed or Flap
– Produce weight
bearing stump

Nursing diagnosis
– Pre-op
– Post-op
• Complications:
hemorrhage,
infections
• Pain
• Impaired
mobility
•Interventions

Pre-op
– physical and mental preparations
– prepare for phantom pain

Post-op
– Hemorrhage
– Pain and phantom pain
– Elevate first 24-48 hours
– Prevent infections
– Prevent contraction, prone position
– Delayed or immediate fitting
Post-op Care: Immediate and Delayed
Prosthesis Fitting

Delayed
– Ace wrap
– Potential
hemorrhage,
swelling
– Stitches out at 2-3
wks
– Temporary
prosthesis with full
wt at 6 wks

Immediate
– Total contact, rigid
dressing
– Compression dec.
edema
– Early wt. bearing
– inc. chance for
Infection
Test Yourself!

Which crutchwalking gait
should the B-K
amputee with a
prosthesis use?
– a. swing-through
gait
– b. 3 point
– c. 4 point
– d. swing-to gait
Amputation home
page
Teaching

Stump bandaging
– Wrap distal to
proximal
– Produce cone
shape

Stump care
– Stump sock, stump
shrinker
– Keep clean
The Goal: coneshaped, wellhealed stump!
Teaching




Weight Control
Temperature control
Muscle
strengthening
Positioning

Hydraulic
prosthesis
Replanation


Criteria
Interventions
– Keep body part
– Plastic bag, /ice
– Elevate stump
– No tourniquet
– Saline dressing

Post-op Care
– Adequate
circulation:
arterial/venous
– Use of leeches
– Prevent
infection
– Prevent platelet
agglutination
– Psychological
support
What initial action
should be taken with
traumatic
amputation?
replantation
What criteria
determine the
viability of the
severed part with
amputation?
Indications for Use of Leeches

Useful on tissue
with impaired
circulation
– dusky, blue skin
color
– brisk capillary
return
– rapid, dark pinprick
response

Contraindicated
with impaired
arterial circulation