Amputation

What is amputation?
Amputation is the removal of a limb by trauma, medical illness, 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 is carried out on individuals as a preventative surgery for such problems. A special case is that of congenital amputation, a congenital disorder, where fetal limbs have been cut off by constrictive bands.

A transplant or a prosthesis are the only options for recovering the loss.In the US, the majority of new amputations occur due to complications of the vascular system (the blood vessels), especially from diabetes. Between 1988 and 1996, there were an average of 133,735 hospital discharges for amputation per year in the US.

Types of amputation 

  • Leg amputations
  • Arm amputation
  • Other amputation (nose, ear, breast, eyes, tongue)
  • What are the causes of amputation? 
  • Circulatory disorders (Diabetes related infection)
  • Neoplasm ( Cancerous bone or soft tissue tumours )
  • Trauma (Sever limb injury)
  • Deformities ( deformed limb )
  • Infection ( bone infection )
  • Traumatic amputations ( serious accident )

Treatments  The development of the science of microsurgery over last 40 years has provided several treatment options for a traumatic amputation, depending on the patient’s specific trauma and clinical situation:
1st choice: Surgical amputation – break – prosthesis.
2nd choice: Transplantation of other tissue – plastic reconstruction.
3rd choice: Re-plantation – reconnection of amputated limb, by microscope.
4th choice: Transplantation of cadaveric hand.

Preventions 
Methods in preventing amputation depend on the problems that might cause amputations to be necessary. Chronic infections, often caused by diabetes or decubitus ulcers in bedridden patients, are common causes of infections that lead to gangrene, which would then necessitate amputation. There are two key challenges: first, many patients have impaired circulation in their extremities, and second, they have difficulty curing infections in limbs with poor vasculation (blood circulation).
Crush injuries where there is extensive tissue damage and poor circulation also benefit from hyperbaric oxygen therapy (HBOT). The high level of oxygenation and revascularization speed up recovery times and prevent infections.
A study found that the patented method called Circulator Boot achieved significant results in prevention of amputation in patients with diabetes and arteriosclerosis. Another study found it also effective for healing limb ulcers caused by peripheral vascular disease.
The boot checks the heart rhythm and compresses the limb between heartbeats; the compression helps cure the wounds in the walls of veins and arteries, and helps to push the blood back to the heart.
For victims of trauma, advances in microsurgery in the 1970s have made re-plantations of severed body parts possible.

Call your doctor if any of these occur:

  • Increased swelling in the residual limb
  • Poorly fitting prosthesis
  • Pain that can’t be controlled with the medication you’ve been given
  • Signs of infection, such as fever or chills
  • Persistent nausea or vomiting
  • Increased symptoms of depression
  • Increasing redness, swelling, increasing pain, excess bleeding, or discharge from the incision site
  • New or persistent cough, shortness of breath, or chest pain
  • Joint pain, fatigue, stiffness, rash, or other new symptoms

If you think you have an emergency, call for emergency medical services right away.

Further Information:
Diabetes UK – www.diabetes.org.uk/amputation 
American Diabetes Association – www.diabetes.org/amputation 
Amputee Coalition of America – www.amputee-coalition.org

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