Amputation answers Amputations Definitions Levels of Amputations *Goal = circulation, extremity length & function Diagnostic Studies
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 Types of amputations
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
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 Post-op Care: Immediate and Delayed Prosthesis Fitting
Test Yourself! Amputation home page • Which crutch-walking gait should the B-K amputee with a prosthesis use? • a. swing-through gait • b. 3 point • c. 4 point • d. swing-to gait
Teaching • Stump bandaging • Wrap distal to proximal • Produce cone shape • Stump care • Stump sock, stump shrinker • Keep clean The Goal: cone-shaped, well-healed stump!
Weight Control Temperature control Muscle strengthening Positioning Hydraulic prosthesis Teaching
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 Replanation
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