AMPUTATION

 

DEFINITION:-

                                     Amputation is surgery to remove all or part of an arm or leg. It may be done to treat injury, disease or infection. It may also be done to remove tumors from bones and muscles.

PURPOSES:-

v Poor blood flow when arteries become narrowed or damaged especially occurs in the arms or legs which is called peripheral arterial disease or PAD..

v  Injury, such as severe burn or accident, or a cancer in a limb.

v  Amputation may also be done for serious infections that do not respond to antibiotics or other treatment.

v  It is done due to neuroma (a thickening of nerve tissue), or frostbite.

 TRAUMATIC AMPUTATION:-

                Traumatic amputation is the loss of a body part -- usually a finger, toe, arm, or leg

 that occurs as the result of an accident or injury.

CAUSES:-

                            Traumatic amputations usually result from factory, farm, power tool accidents, or from motor vehicle accidents. Natural disasters, war, and terrorist attacks can also cause traumatic amputations.

SYMPTOMS:-

v  A body part that has been completely or partially cut off

v  Bleeding (may be minimal or severe, depending on the location and nature of the injury)

v  Pain (the degree of pain is not always related to the severity of the injury or the amount of bleeding)

v  Crushed body tissue (badly mangled, but still partially attached by muscle, bone, tendon, or skin)

FIRST AIDS:-

1.     Check the person's airway (open if necessary); check breathing and circulation. If necessary, begin rescue breathing, CPR, or bleeding control.

2.     Try to calm and reassure the person as much as possible. Amputation is painful and very frightening.

3.     Control bleeding by applying direct pressure to the wound. Raise the injured area. If bleeding continues, recheck the source of the bleeding and reapply direct pressure, with help from someone who is not tired. If the person has life-threatening bleeding, a tight bandage or tourniquet will be easier to use than direct pressure on the wound. However, using a tight bandage for a long time may do more harm than good.

4.     Save any severed body parts and make sure they stay with the person. Remove any dirty material that can contaminate the wound, if possible. If possible, gently rinse the body part if the cut end is dirty.

5.     Wrap the severed part in a clean, damp cloth, place it in a sealed plastic bag and place the bag in an ice water bath.

6.     Do NOT directly put the body part in water without using a plastic bag.

7.     Do NOT put the severed part directly on ice. Do NOT use dry ice as this will cause frostbite and injury to the part.

8.     If cold water is not available, keep the part away from heat as much as possible. Save it for the medical team, or take it to the hospital. Cooling the severed part will keep it safe for reattachment for about 18 hours. Without cooling, it will only remain safe for about 4 to 6 hours.

9.     Keep the person warm.

10.Take steps to prevent shock. Lay the person flat, raise the feet about 12 inches, and cover the person with a coat or blanket. Do NOT place the person in this position if a head, neck, back, or leg injury is suspected or if it makes the victim uncomfortable.

11.Once the bleeding is under control, check the person for other signs of injury that require emergency treatment. Treat fractures, additional cuts, and other injuries appropriately.

12.Stay with the person until medical help arrives.

FOOT AMPUTATION:-

                           Leg or foot amputation is the removal of a leg, foot or toes from the body. These body parts are called extremities. Amputations are done either by surgery or they occur by accident or trauma to the body.

REASONE FOR FOOT AMPUTATION:-

v  Reasons for having an amputation of a lower limb are:

v  Severe trauma to the limb caused by an accident

v  Poor blood flow to the limb

v  Infections that do not go away or become worse and cannot be controlled or healed

v  Tumors of the lower limb

v  Severe burns or severe frostbite

v  Wounds that do not heal

v  Loss of function to the limb

RISK:-

Risks of any surgery are:

v  Blood clots in the legs that may travel to the lungs

v  Breathing problems

v  Bleeding

v  Risks of this surgery are:

v  A feeling that the limb is still there. This is called phantom sensation. Sometimes this feeling can be painful. This is called phantom pain.

v  The joint closest to the part that is amputated loses its range of motion, making it hard to move. This is called joint contracture.

v  Infection of the skin or bone.

v  The amputation wound does not heal properly.

BEFORE PROCEDURE:-

v  Collect the history of patient regarding medicines, supplements, or herbs you bought without a prescription

v  Stop drinking  a lot of alcohol during the days before  surgery,  stop taking aspirin, ibuprofen (such as Advil or Motrin), warfare (Coumadin), and any other medicines that make it hard for your blood to clot.

v  Control diabetes, follow your diet and take medicines as usual until the day of surgery.

v  Keep the patient NPO.

·         AFTER PROCEDURE:-

§  The end of leg (residual limb) will have a dressing and bandage that will remain on for 3 or more days. Pain for the first few days.

  • v  Take medication at proper time.
  • v  Maintain hygiene.
  • v  Do periodical dressing.
  • v  Follow doctors order.

Before leaving the hospital begin learning how to:

v  Use a wheelchair or a walker

v  Stretch muscles to make them stronger

v  Strengthen arms and legs

v  Begin walking with a walking aid and parallel bars

v  Start moving around the bed and into the chair in hospital room

v  Keep joints mobile

v  Sit or lie in different positions to keep joints from becoming stiff

v  Control swelling in the area around amputation

v  Properly put weight on  residual limb. You will be told how much weight to put on your residual limb. You may not be allowed to put weight on residual limb until it is fully healed.

v  Fitting for prosthesis, a manmade part to replace your limb, may occur when your wound is mostly healed and the surrounding area is no longer tender to the touch.

PROGNOSIS:-

                            Recovery and ability to function after the amputation depend on many things. Some of these are the reason for the amputation, whether you have diabetes or poor blood flow, and your age. Most people can still be active following amputation.

Comments

Post a Comment

Popular posts from this blog

ICEBERG PHENOMENON OF DISEASE

Image
  DESCRIPTION v   According to this concept, the disease in the community is compared to an Iceberg. v   When a piece of ice is allowed to float on water, a small portion is visible and a major portion is submerged in the water. v   The visible tip of ice is compared to clinical cases, which the physician sees in the community. v   The major submerged portion of ice corresponds to hidden mass of  unrecognized  diseases such as latent cases, in apparent, carriers, asymptomatic and undiagnosed cases in the community, which are responsible for the constant prevalence of the disease in the community. v   In some diseases like HTN, diabetes, anemia, malnutrition, mental illness etc. the unknown morbidity is more than the known morbidity in the community and constitutes an important, undiagnosed reservoirs of disease in the community.
Read more

INCREASED INTRACRANIAL PRESSURE

Image
  OVERVIEW The rigid intracranial vault contain brain tissue 1.400 gram, blood 75 ml & CSF 75 ml.  The volume and pressure of these three component are usually in a state of equilibrium & maintain ICP.    Intracranial pressure are measured in the lateral ventricle, the normal pressure is 5-15 mmHg, 20mmHg above most be treated.    ICP can be measured by use of  pressure transducer. MONRO KELLIE HYPOTHESIS- (MENRO KELLIE DOCTORINE) ·          This Hypothesis says about dynamic equilibrium of cranial content. ·          It says that inside the skull there is a limited space for expansion of cranial content. ·          When there is increase in any one of the three content ( brain tissue, blood & CSF) it change in volume of other. Because there is limited space it expand it cause;- ²   Shift the CSF ² ...
Read more

PREGNANCY SIGN

Image
  PRESUMPTIVE SIGN 1.        Amenorrhea 2.        Nausea & vomiting 3.        Increase size & increased feeling of fullness in breast 4.        Pronounced nipples 5.        Urinary frequency 6.        Quickening:- The first perception of fetal movement by the mother may occur at the 16 th to 20 th week of gestation 7.        Fatigue 8.        Discoloration of the vaginal mucosa PROBABLE SIGN 1.        Uterine enlargement 2.         Hegar’s Sign : Compressibility & softening of the lower uterine segment that occur at about week 6. 3.        Goodell’s Sign: Softening of the cervix that occur at the beginning of the...
Read more