Amputation
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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