[L. amputare, to cut around]
Removal of a limb, body part, or organ, usually as a result of surgery but, occasionally, of trauma. In western countries during peace time, the most common reason for loss of a limb is peripheral vascular disease, e.g., a blockage to blood flow to the legs caused by cigarette smoking, hypertension, high cholesterol, physical inactivity, or uncontrolled diabetes mellitus. Amputation can also result from injuries occurring accidentally, e.g., in battle or while working.
Each year, about 185,000 Americans undergo limb amputation. Vascular disease and injuries are responsible for most limb removals. Approx. 2 million living Americans have undergone amputation of a limb.
Immediately after amputation, vital signs are assessed; the dressing is observed for bleeding at least every 2 hr; drain patency is checked; and the amount and character of drainage are documented. Limb circulation is ascertained by checking pulses, skin color, and temperature. Postoperative pain is managed by intravenous and, later, by oral analgesics. To prevent formation of contractures, the patient is encouraged to walk, change position, rest in proper body alignment with the residual limb extended rather than bent, do range-of-motion exercises (esp. extensions), and, finally, muscle-strengthening exercises as soon as these are prescribed. Residual limb-conditioning exercises and correct residual limb bandaging (application of graded, moderate pressure to mold the residual limb into a cone shape that allows a good prosthesis fit) assist limb shrinkage. The residual limb may initially have a rigid cast. The patient is instructed in skin hygiene; to massage the limb; to examine the entire limb daily, using a mirror to see hidden areas; and to report symptoms such as swelling, redness, excessive drainage, increased pain, and residual limb skin changes (rashes, blisters, or abrasions). The patient is taught to bandage the residual limb or, when it is dry, to apply a residual limb shrinker (a custom-fitted elastic stocking that fits over the residual limb) and is advised against applying body oil or lotion because it can interfere with proper fit of a prosthesis. The need for constant bandaging until edema subsides and the prosthesis is properly fitted, the use of a residual limb sock, and proper care of the prosthesis are explained. The patient is encouraged to verbalize anger and frustration; to cope with grief, self-image, and lifestyle adjustments; and to deal with phantom limb sensation if this occurs. The patient may require referral to a local support group or for further psychological counseling.
SEE: Chopart, François
Amputation of parts of the fetus in utero. It was formerly believed to be caused by constricting bands but is now believed to be a developmental defect.
Amputation in which two flaps of soft tissue are formed to cover the end of the bone.
Amputation at a joint.
Amputation at a site other than a joint.
SEE: Jaboulay amputation
SEE: Pirogoff amputation
Amputation performed before inflammation or infection sets in.
The technique of removing the coronal portion of an exposed or involved vital pulp in an effort to retain the radicular pulp in a healthy, vital condition.
SYN: SEE: pulpotomy
Amputation performed after onset of infection.
Nonsurgical separation of an extremity or digit.
The sudden amputation of some part of the body due to an accidental injury.
SEE: Tripier amputation
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