LEG AMPUTATION: A BEFORE AND AFTER GUIDE
The experience of undergoing an amputation is devastatingly life-changing. It needs a skilled team of doctors to put enough effort to bring the patient out of such a trauma both physically and mentally.
CAUSES OF AMPUTATION
NECROSIS: Necrosis means the death of cells. It occurs due to inadequate blood supply that deprives cells of oxygen. Without oxygen, the anaerobic condition causes ATP depletion that leads to cell death. TUMORS: The tumors of muscles and bones are often malignant. Sometimes the radio and chemotherapy are not enough to eradicate cancer and there is a need for amputation to prevent further spread. INFECTIONS: Many pathogenic infections can cause muscle and bone damage. In these infections, necrosis can spread to different parts of the body and can be life-threatening. INJURY: Often in road traffic accidents and other violent actions the avulsion injury causes loss of a limb. In other conditions, the limb may be saved for the time being but the cell death puts the patient at the risk of surgical amputation.
PREPARATION OF THE SURGERY
Before the surgery is performed the consultant must inform the patient and the family of the entire procedure and written consent is to be taken. The doctor informs why the procedure is important, the consequences of the condition if the patient resists and how the surgery will be performed. Also, the doctor guides the family about the outcomes of the surgery, the medication and follow-ups. In this situation, the family is counseled emotionally by the team.
THE SURGICAL PROCEDURE
Amputation is performed under general or spinal anesthesia that numbs the body. The surgeons remove the damaged tissue or the tumor. There are several methods to determine the part from where the limp is to be amputated. These include the comparison between the temperatures of skin overlying the healthy and damaged tissues, whether the skin is sensitive to touch, reddened skin and lastly by checking for a pulse close to the area that is being amputated.
After the removal of unhealthy tissues, the bone is crushed and evened, the arteries and veins are ligated and muscles are shaped.
THE PROCESS OF RECOVERY
After the anesthesia wears off, the actual process of healing begins. In these circumstances, the patient needs emotional help and counseling. During the process of recovery, the patient hospitalized for a week to fourteen days depending upon the surgery and during this period the patient learns to keep up with his condition.
DRESSING OF THE WOUND: It is the work of the hospital staff to dress the wound and teach the patient or a family member how to change it. MEDICATIONS: The doctor prescribes medication for pain relief and the underlying condition such as infection or diabetes mellitus. PHYSIOTHERAPY: The therapy and exercises are monitored by the doctor. It starts with gentle movements and stretches soon after the surgery to improve muscle strength, restore muscle activity and prevent contractures. EMOTIONAL SUPPORT: An amputee needs to seek emotional support since the process is traumatizing. With counseling, the patient can prevent psychological disorders like anxiety, PTSD and depression.
The guidance of the procedure is necessary for the patient and his family to look on the brighter side despite the circumstances. According to research, the rate of psychological disorders declined in patients who were counseled by their doctors pre-surgery.