Amputations

1
Amputations
Amputation answers

• Definitions
• Levels of Amputations
• Goal circulation, extremity length function
• Diagnostic Studies

2
Types of amputations

• Open of Guillotine
• Required if infection present
• Late closure
• Closed or Flap
• Produce weight bearing stump

• Nursing diagnosis
• Pre-op
• Post-op
• Complications hemorrhage, infections
• Pain
• Impaired mobility

3
Interventions

• Pre-op
• physical and mental preparations
• prepare for phantom pain
• Post-op
• Hemorrhage
• Pain and phantom pain
• Elevate first 24-48 hours
• Prevent infections
• Prevent contraction, prone position
• Delayed or immediate fitting

4
Post-op Care Immediate and Delayed Prosthesis
Fitting

• Delayed
• Ace wrap
• Potential hemorrhage, swelling
• Stitches out at 2-3 wks
• Temporary prosthesis with full wt at 6 wks

• Immediate
• Total contact, rigid dressing
• Compression dec. edema
• Early wt. bearing
• inc. chance for Infection

5
Test Yourself!
Amputation home page

• Which crutch-walking gait should the B-K amputee
  with a prosthesis use?
• a. swing-through gait
• b. 3 point
• c. 4 point
• d. swing-to gait

6
Teaching

• Stump bandaging
• Wrap distal to proximal
• Produce cone shape
• Stump care
• Stump sock, stump shrinker
• Keep clean

The Goal cone-shaped, well-healed stump!
7
Teaching

• Hydraulic prosthesis

• Weight Control
• Temperature control
• Muscle strengthening
• Positioning

8
(No Transcript)
9
Replanation

• Post-op Care
• Adequate circulation arterial/venous
• Use of leeches
• Prevent infection
• Prevent platelet agglutination
• Psychological support

• Criteria
• Interventions
• Keep body part
• Plastic bag, /ice
• Elevate stump
• No tourniquet
• Saline dressing

10
What initial action should be taken with
traumatic amputation?
11
replantation
What criteria determine the viability of the
severed part with amputation?
12
Indications for Use of Leeches

• Useful on tissue with impaired circulation
• dusky, blue skin color
• brisk capillary return
• rapid, dark pinprick response
• Contraindicated with impaired arterial circulation