Amputation Ppt.x

1. Shri Shankaracharya College Of Nursing, Hudco ,Bhilai
Subject- Medical Surgical Nursing
Topic - AMPUTATION
Presented To Presented By
Mrs. MEGHA BARCHHIHA MEHAK
Assistant professor BSC Nursing II year
SSCN

2. INTRODUCTION
Amputation is an acquired condition that results in loss of a limb, usually from injury
,disease and surgery. The word Amputation is derived from a latin word
“Amputare” which means “to cut off” Amputation is a complex removal of injured and
Reformed part.

3. DEFINITION
Amputation is defined as the partial or total removal of an extrimity
(According to Brunner and Siddharth)
Amputation refers to the surgery to remove all or part of a limb or extremity
(According to Suresh K.Sharma)

4. CAUSES
● Trauma - crush injuries, Burns, frost bite, electrical burns, fulaminating gas
gangrene
● Diseases- Peripheral vascular disease, diabetes, blood clot
● Chronic osteomyelitis
● Bone tumor
● Congenital abnormalities
● Surgery- To remove tumor from bones and muscles

5. PURPOSE
● To remove tissue that no longer had an adequate blood supply
● To remove malignant tumor
● Because of severe trauma to the body part

6. Level Of Amputation
● Partial foot Amputation
● Transtarsal Amputation
● Ankle disarticulation
● Trans tibial Amputation (below knee Amputation )
● Knee disarticulation
● Trans femoral knee Amputation (above knee Amputation)
● Hip disarticulation
● Trans pelvic Amputation
● Partial hand Amputation

7. Continue…….
● Wrist disarticulation
● Trans radial Amputation (below elbow Amputation)
● Elbow disarticulation
● Trans humeral Amputation (above elbow Amputation)
● Shoulder disarticulation

8. TYPES OF AMPUTATION
● On the basis of Amputated part
1. Amputated finger
2. Amputated thumb
3. Amputated arm
4. Amputated toe
5. Amputated leg
6. Amputated lower leg
● On the basis of Type of survey
1. Open Amputation
2. Closed Amputation

9. Continue……
● OPEN AMPUTATION - The open Amputation is performed when infection is
present or likely to develo due to circumstances of the injury or
amputation.Tissue and bone are sevgred at same level , and the wound is
not closed, but left open to drain . Bulky dressing cover the stump end.
● CLOSED AMPUTATION - The closed amputation is preferred method as it
heals faster and allows 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.

10. The Site Of Amputation
● The blood supply available to the remaining limb
● The functional ability of the remaining limb
● The fitting of the functional prosthesis
● The patient age and overall physical condition
● The patient muscle strength
● The patient ability to learn.

11. DIAGNOSTIC EVALUATION
Pre operatively some diagnostic test was done.
1. Routine blood heamtology, biochemistry and blood cross matching,
coagulation study done
2. Doppler flowmetry, segmented blood pressure determination, arteriography
and venography are performed.
Post operative diagnostic test
1. CBC done to monitor blood loss
2. WBC count to rule out infection
3. Blood biochemistry checked to evaluate electrolytes

12. HEALING OF AMPUTATION SITE
● Rigid and compressed dressing is applied over stump that promote healing
and prevent infection and minimize edema.
● Soft dressing can also be applied if you have to observe the stump for
infection.
● Stump is prepared for prosthesis by pushing it into first soft and then harder
surface.
● Stump may be wrapped in an ice bandage to form its conical shape and to
prevent edema. Bandage is applied from distal to proximal extremity.

13. COMPLICATIONS
● Hematoma
● Infection
● Delayed healing
● Contractures
● Skin flap necrosis
● Deformity of joints
● Neuroma

14. NURSING INTERVENTION
● Collect health history regarding previous health history pain, occupation,
lifestyle,nutritional status and psychological status.
● Physical examination - colour, sensation, gangrene, edema.
● Asses the wound for drainage, bleeding, necrosis.
● Asses for complications
● Asses psychological state of a client.
● Asses pain and provide pain relieving therapies.
● Administer medication as indicated eg- opiod analgesics, anti-inflammatory
agents, anti depressants, anti seizure drugs.
● Maintaining peripheral tissue perfusion.
● Preventing wound infection.

15. Continue……
● Advice patient to do mild exercises to promote circulation and quick healing
of wound.

16. Health Education
● Inspect the wound daily for abrasion, blistering and redness.
● Perform daily hygiene,wash stump with mild soap and carefully rinse it and
dry it.
● Apply nothing ( alcohol,cream,lotion,powder) after it is bathed.
● Put on prosthesis immediately when arising and keep it on all day to reduce
swelling.
● Continue prescribed exercises to prevent weakness.
● Advice patient to use assistive devices like walker (for elderly patients)and
crutches