Preparing for your amputation surgery.

Amputation due to circulatory disorders

One of the most common causes of amputations in the Western world is occlusive arterial disease (inadequate blood flow due to narrowing of the arteries). With a circulatory disorder, the supply of oxygen to the leg is no longer sufficient, and those affected often experience pain and find walking uncomfortable. Their leg or foot may feel colder than the rest of the body and sometimes appear bluish in colour. A lower limb amputation is only performed if blood circulation cannot be restored by other vascular surgery procedures.

Amputation due to diabetic foot syndrome

Diabetic foot syndrome (DFS) is one of the most common causes of leg or foot amputations. Although the number of people with diabetes is rising, the number of amputations is changing very little thanks to better disease control, treatment methods and patient education.

High blood sugar levels can damage the nerves and blood vessels in your body. If the nerves in your legs or feet become damaged (neuropathy), you may no longer be able to feel pain — this can lead to cuts or ulcers going unnoticed and resulting in infections.

Diabetes can also reduce perspiration, causing your feet and legs to dry out and crack, and uncontrolled diabetes may affect circulation, making it more difficult for the body to deliver nutrients to wounds and slowing healing.

Amputation after an accident

The frequency of amputations after accidents — including work and traffic accidents — has decreased considerably in the Western world. There are many reasons for this, including higher occupational health and safety standards as well as advances in medical treatment. Progress in intensive care and surgery means that nerves, vessels, bones and soft tissue of injured limbs can be restored in many cases, so amputation is not always required as the last resort.

Amputation due to cancer tumours

Amputations due to cancer are relatively rare. However, tumours close to the knee or in the area of the hip are the most common to result in amputation. This occurs when the tumour needs to be removed to save the patient's life and prevent the spread of cancer cells to other parts of the body.

Amputation after an infection

Any wound is open to infection; however, amputations resulting from infections have become extremely rare since the discovery of antibiotics. High sterile standards in medical treatment and tetanus shots are another reason for the decrease. Nevertheless, remaining vigilant — even with the tiniest injury — and looking out for signs of inflammation, reddening of the skin, swelling, fever and pain in a wound can help.

Surgeon

Your surgeon will meet with you before the amputation operation to advise on the amputation level and may coordinate with your prosthetist. After the surgery, your surgeon will monitor your recovery and rehabilitation.

Nursing staff

After your amputation, the nursing staff in the hospital will look after your wound healing and ensure the correct positioning and compression of your residual limb. Ideally, this will be coordinated with your surgeon, prosthetist and physiotherapist.

Physiotherapists and occupational therapists

Physiotherapists and occupational therapists assist you in the hospital, during rehabilitation and in everyday life. Their role is to get you moving, strengthen and stretch your muscles, and help you learn — and continue to improve — walking and coping with daily life. Therapists can also help with compression therapy in the hospital.

Prosthetist

Your prosthetist plays a central role after your amputation surgery. They will fit you with a suitable prosthesis and offer advice on any questions you have. Leading up to an amputation, your prosthetist may discuss with your surgeon what your residual limb should look like if possible. They can recommend experienced physiotherapists and put you in contact with other amputees, and you can also ask them about home conversions or vehicle alterations.

When fitting you with a prosthesis, your prosthetist will clarify your needs and preferences and discuss the various treatment options with you. Based on this, they select the appropriate prosthetic components and fabricate your prosthesis with a customised socket.

Relatives and social environment

Your family and friends will also contribute to your rehabilitation by supporting you to the best of their ability in daily life. The exact role they play will depend on your needs and requirements, but they can help with everyday tasks as well as the daily use of your prosthesis. Depending on your situation, outpatient nurses can also assist you with using your prosthesis and take charge of compression and mobilisation in everyday life.