What to expect before, during and after amputation
The most important goal of your entire treatment from surgery to rehabilitation, to the fitting of your prosthesis is to help you attain the most function and mobility possible, so you can lead an active life.
Your rehabilitation team, which includes your doctors, therapists, prosthetists and of course, you and your loved ones, will help you achieve the most independence possible. On average, this rehabilitation process takes between two to six months, although this can be affected by various factors, including your level of motivation and how well your prosthesis fits.
Recommendations with regard to your therapy and rehabilitation are provided below. However, the instructions from your rehabilitation team always take priority since this team is best able to evaluate your individual situation.
Whether you’ve known about your amputation surgery for a while, or just found out, remember that you’re not alone. Your treatment team is there to support you, answer question—and find the best solutions for you.
If you are to undergo planned amputation surgery, you will be examined in detail several times before the surgery. Your doctors will explain what will happen both during and after the operation.
During these discussions, you have the opportunity to ask any questions which are important to you. It’s a good idea to take notes of what you want to ask the doctor before the discussions so that you don't forget anything. Remember that it’s their job to explain it all clearly to you.
What does amputation level mean?
The term amputation level is used to describe the location at which the body part is amputated.
The amputation level is determined by the doctor before the operation and is based on the reason for the amputation. For planned interventions, a prosthetist is normally consulted as well in order to clarify which amputation level is suitable for subsequent fitting of the prosthesis.
There are many different amputation levels in the hand. They range from a digit or finger amputation, to a metacarpal amputation through the bones of the hand.
When there is less need for—or difficulty in fitting—a prosthesis that offers increased function, Cosmetic silicone prostheses are sometimes used. However, a prosthesis is not always used with the hand.
Immediately after your operation, the focus will be on your recovery and the healing of your arm, also referred to as your residual limb. A healthy recovery is important so that you can start rehabilitation soon and be fitted with a prosthesis.
Your treatment team will decide when you can start with intensive rehabilitation based on how your recovery is going. During your rehabilitation process, you will be fitted with a prosthesis tailored to your specific needs, and supported by a rehabilitation team that could include physicians, physical therapists and occupational therapists, a prosthetist and nursing staff. These professionals are there to support you and to ensure that you are well prepared. During rehabilitation you will learn how to properly care for your residual limb, as well as the rest of your body.
Before you can wear a prosthesis, your residual limb must be healed and have attained the proper shape. This means that all fluids that accumulated due to the operation have been removed through compression therapy and that the residual limb swelling (edema) has subsided.
What to expect after an amputation surgery
When you wake up from the anesthesia, your arm will have likely been treated with simple bandages with a small drainage tube leading out of it. This tube was laid into the wound during the operation so that wound seepage and blood can flow out of the wound, and will be removed from the wound during the healing process.
In most cases the amputation wound closes and forms a scar within the first three to four weeks. But even if the scar looks like it has healed well from the outside and only the color of the scar tissue is changing slightly, complete healing of the scar may take significantly longer.
During this period compression therapy and skin care creams are enormously important in helping the scar tissue remain soft and pliable—while simultaneously making it stable enough to wear a prosthesis.
The rehabilitation process
Once your residual limb has been properly formed you’ll learn more about your prosthesis. You’ll be instructed in how to take care of it as well as your residual limb, and you’ll also begin training with it.
There are three main types of upper limb prosthetic fittings: body-powered, myoelectric and hybrid, which is a combination of the other two.
Body-powered systems use a harness with cables to move the prosthesis. By engaging larger muscles, the cables can open and close a hook or hand, as well as an elbow or shoulder joint.