Amputation Health Article

Definition

Amputation is the intentional surgical removal of a limb or body part. It is performed to remove diseased tissue or relieve pain.

Purpose

Arms, legs, hands, feet, fingers, and toes can all be amputated. Most amputations involve small body parts such as a finger, rather than an entire limb. More than 60, 000 amputations are performed in the United States each year.

Amputation is performed for the following reasons:

• to remove tissue that no longer has an adequate blood supply
• to remove malignant cancers (almost exclusively in the case of osteogenic sarcoma or other sarcomas)
• as a result of severe trauma to the body part

The blood supply to an extremity can be cut off because of injury to the blood vessel, hardening of the arteries, arterial embolism, impaired circulation as a complication of diabetes mellitus, repeated severe infection that leads to gangrene, severe frostbite, Raynaud's disease, or Buerger's disease.

More than 90% of amputations performed in the United States are due to circulatory complications of diabetes, the most common cause of non-traumatic leg and foot amputations.

Precautions

Amputation cannot be performed on patients with uncontrolled diabetes mellitus, heart failure, or infection, and is also inadvisable for patients with blood clotting disorders.

Description

Amputations can be either planned or emergency procedures. Injury and arterial embolisms are the main reasons for emergency amputations. The operation is performed under regional or general anesthesia by a general or orthopedic surgeon in a hospital operating room.

Details of the operation vary slightly depending on what is to be removed. The goal of all amputations is twofold: to remove diseased tissue so that the wound will heal cleanly, and to construct a stump that will allow the attachment of a prosthesis or artificial replacement part.

The surgeon makes an incision around the part to be amputated. The part is removed, and the bone is smoothed. A flap is constructed of muscle, connective tissue, and skin to cover the raw end of the bone. The flap is then closed over the bone with sutures (surgical stitches) that remain in place for 3 to 4 weeks. Often, a rigid dressing or cast is applied that stays in place for about two weeks.