Indications

peripheral vascular disease: peripheral arterial occlusive
disease acute occlusion d/t embolism, aneurysm
diabetic limb disease necrotizing fasciitis
trauma - severe tissue damage traumatic amputation
infection: includes gas gangrene malignant tumors
nerve injury congenital abnormalities: extra digits,
deformity

Diabetes Complications

micro-vessel damage peripheral neuropathy
ulcers develop infections dec. arterial blood
supply

Other Factors

squamous cell carcinoma acute cardiac failure, CHF,
MI crush injury gun shot bomb
burn work trauma

Goal

max level of independent fx ablation of diseased
tissue decreased morbidity & mortality

Pre-Op Assessment

pt physical condition pt attitude on amputation
amputation type & level of amputation

Pre-Op Education

wound care PT & adapting to new center of
gravity different prosthesis options phantom limb
sensation & pain

Pre-Op NDx:

Risk for Delayed Surgical Recovery
PainAnxiety

Phantom Pain Tx

meds: analgesics, antidepressants, anticonvulsants, topical
agents visual feedback - mirror therapy PT (ROM
& TENS)

Post-Op Nursing Interventions

assess bleeding edema neurovascular
status infection neuroma flexion
contractures pain Tx stump care teaching

Stump Care

inspect daily: redness, blistering, abrasions use
mirror to examine all sides / aspects of stump meticulous
daily hygiene stump sock for cleanliness & comfort
put on prosthesis immediately on arising & wear all day
prescribed exercises to prevent weakness