The fitting of a functional prosthesis.
The patient's age and overall physical condition.
The patient's muscle strength.
The patient's ability to learn.
b. The usual sites for amputation of a lower extremity include the foot, the ankle,
below the knee (BKA), above the knee (AKA), at the hip (hip disarticulation), or at the
pelvis (hemipelvectomy). Usual sites involved in amputation of part of an upper
extremity include the fingers, at the wrist, below the elbow (BEA), above the elbow
(AEA), and at the shoulder (shoulder disarticulation). The shoulder disarticulation, hip
disarticulation, and hemipelvectomy are normally done only in cases of extensive
injuries, malignancy, or gangrene. They are disabling and traumatic procedures, and
done only as a last recourse.
c. Two basic types of amputation procedures are utilized. They are referred to
as open, or guillotine amputation and closed, or flap amputation.
(1) The open amputation is performed when infection is present or likely to
develop due to the circumstances of the injury or amputation. Tissue and bone are
severed at the same level, and the wound is not closed, but left open to drain. Bulky
(2) The closed amputation is the preferred method as it usually heals faster
and allows the patient to be fitted for and begin using a prosthetic device much sooner.
When the tissue and bone are severed, skin flaps are left to cover the stump end.
Drains are placed in the wound and the skin flaps are sutured.
1-52. NURSING CARE AND PATIENT EDUCATION
a. Preoperative care and patient education can be done in cases of elective
amputation. There is time to prepare the patient for what lies ahead. In the case of a
traumatic amputation, this may not be possible. Preoperative nursing care and patient
education for the patient about to undergo amputation of all or part of a limb includes
(1) Build the patient's strength by implementing muscular exercises for the
(2) Improve the patient's nutritional status by encouraging a balanced diet
high in vitamins and minerals and with adequate protein to enhance wound healing.
Maintain adequate hydration.