Your Amputation Surgery

Leg showing amputation below knee. Flap of skin from back of leg covers end of leg. Leg showing amputation below knee. Sutures or staples hold flap of skin in place.

A flap of muscle and skin is brought over the end of the bone and stitched (sutured) or stapled in place. Location of the stitches or staples vary.

Amputation is a surgery to remove a limb or part of a limb. It is done because tissue in the limb is diseased or damaged and can’t be healed. The surgeon saves as much of your limb as possible. This may include joints, such as the knee. But you may not know before the surgery how much of the limb will remain. Amputation is intended to restore your ability to function. This is because removing your diseased or damaged limb can improve your health. Common causes of amputation include peripheral artery disease that causes ischemia, (poor blood supply to an area), trauma, diabetes, infection, and cancer.

During the surgery

You will most likely receive either general anesthesia or a local/regional anesthesia and be completely asleep during the surgery. The surgeon divides damaged tissue from healthy tissue. This includes skin, muscle, bone, blood vessels, and nerves. Then the surgeon removes the damaged part of the limb. The remaining nerves are cut short and allowed to pull back into the healthy tissue. This protects and cushions them. The end of the cut bone is trimmed and the edges are smoothed for comfort. A flap of healthy muscle and skin is left behind when the damaged tissue is removed. The flap is brought snugly over the bone to cover the end of the amputated limb. If there isn’t enough tissue in the flap, the surgeon takes skin or tissue from another part of the body. The flap is then stitched (sutured) or stapled in place. The wound may be left open at first if debris is present or infection is possible. This allows fluid to drain and helps the wound heal cleanly. The wound will later be closed by the surgeon. 

Risks and complications of surgery

  • Further surgery needed to remove more of the limb

  • Poor wound healing

  • Infection

  • Severe bleeding (hemorrhage)

  • Pain, including nerve-related symptoms, chronic pain, and phantom limb pain

  • Blood clots

  • Heart problems (heart attack, arrhythmias, heart failure)

  • Flexion contractions

  • Depression

  • Death

After the surgery

When you wake up, you’ll be on pain medicine to help keep you comfortable. It will likely be given along with fluids through an IV (intravenous) line that’s placed in a vein. Later, you’ll be switched to oral pain medicines as needed. You’ll have a splint or some other form of pressure dressing on your residual limb. This helps control swelling and aid healing. You may be started on blood thinner medicine to prevent blood clots depending on your surgery. You will receive antibiotics just before surgery. These may continue after surgery, as well. You may have a urinary catheter for a short time.

Recovering in the hospital

You’ll stay in the hospital for about 3 to 7 days. Your stay may be longer or shorter. This will depend on your overall health and how quickly you heal. While in the hospital, you’ll begin physical therapy. This will help stretch and strengthen your muscles. It will also help prevent shortening of muscle or joint tightening (contracture). You’ll learn how to safely transfer between your bed and other surfaces, such as a chair. This helps prevent falls so that your healing wound is protected. Later, you may be able to move around using a walker or crutches, if your surgery was on a lower limb. You may work with an occupational therapist. He or she can help you resume tasks, such as showering and dressing.

Going home

You’ll be ready to go home when your pain is controlled by oral medicines. You’ll also need to be able to move safely between surfaces. If you’re having trouble with these tasks, you may need further help. This may mean going to a nursing center or a rehabilitation unit, if your amputation was on the lower limb. If your surgery was on a lower limb, you’ll likely go home in a wheelchair. It may have an a special platform called an amputee board to support your residual limb. You may need to arrange for help at home.

At home

At home, you’ll need to keep doing the exercises you were taught in the hospital. This will help prepare your residual limb to be fitted for a prosthesis (artificial limb). At all times, take care to move around safely to avoid falls. Falling can reopen your wound. Use your wheelchair, walker, or crutches at all times, if you received them.

Following up with the surgeon

You’ll need to follow up with the surgeon about 5 to 7 days after you go home. The surgeon will check how your wound is healing. The stitches or staples will likely come out about 2 to 3 weeks after surgery. This could be longer if you heal more slowly due to other health problems. After healing is complete, you may be able to be fitted for a prosthesis.

When to call the doctor

Check your wound at home as directed by the surgeon. Call your surgeon right away if you have any of the following problems:

  • Fever of 100.4ºF (38.0°C) or higher, or as directed by your provider

  • Chills

  • Red streaks on the skin around the wound

  • Thick, cloudy, or yellow-brown drainage or odor from the wound

  • The skin pulls apart at the wound (wound separation)

  • Severe increase in pain

  • Excessive bleeding