What is an amputation?

An amputation is the loss or removal of a part of your body, such as:

• a finger
• a toe
• an arm
• a leg

The loss of part of your body can be a life-changing experience, but there is help and support available.

There are several reasons why you might need to have an amputation. These can include:

• diabetes complications
• peripheral vascular disease (narrowing of the arteries leading to your legs and feet)
• severely reduced blood supply to a limb
• severe infections
• cancer
• serious injury

What are the benefits of an amputation?

An amputation can remove part of a limb that may be affected by infection or cancer. This may:

• control your condition
• help manage your pain
• save the rest of your limb

In some cases, amputation may be needed to save your life.

How can I prepare for an amputation?

Amputations can be done as emergency or elective (planned) surgery. Finding out that you are facing an amputation can be difficult and scary.

Before planned amputations, you will meet with your surgeon. They will discuss the operation with you and any preparation needed.

It's important to ask your doctor about the benefits and risks of any surgery.

It may help to make a list of questions before your appointment. This is so that you can discuss these with your doctor. Taking a relative or friend with you to these appointments may also be helpful.

Before an amputation you may need:

• a thorough medical examination
• a psychological assessment
• to make changes to your home or work environment

Before your surgery, an anaesthetist (specialist doctor) will discuss with you the type of anaesthetic that will be best for you.

What does an amputation involve?

Your surgeon will remove your limb, or part of your limb, under anaesthetic.

Your wound will be closed with stitches or staples. A drain may be put under your skin. This allows excess fluid to drain away. Your wound will be covered with a dressing and bandage.

Your wound will be sore after surgery, but this should start to ease in 2 to 5 days. You can use pain relief medicine to keep you comfortable after your surgery.

How soon will I recover from an amputation?

Rehabilitation will help you recover and regain your independence.

Usually, several healthcare professionals will be involved in your care, including a:

• rehabilitation doctor
• nursing team
• occupational therapist
• physiotherapist
• prosthetist (healthcare worker who looks after the design and fit of a prosthesis)
• social worker

Your healthcare team will give you advice on how to care for your wound and your residual limb (your limb or stump after amputation).

Your physiotherapist and occupational therapist will work out a rehabilitation program to help you return to work and other activities.

They will also help you learn to use your prosthesis or mobility aids.

Your physiotherapist will start working with you a few days after surgery.

It may take 6 to 12 months to recover from and adjust to your amputation.

Prosthesis

If you have lost a limb, a prosthesis (artificial limb) or mobility device can help you to regain function.

You may be able to have these fitted after your surgery. Your prosthetist and healthcare team will help you prepare for this.

Psychological support

For some people, losing a limb is like losing a loved one, and you will need to grieve.

You may feel:

• angry
• frustrated
• upset
• scared

Coming to terms with the psychological impact of an amputation is just as important as coping with the physical changes.

Peer support can be helpful — peer support volunteers are people who have experienced and lived with limb loss.

It can also help to join a support group, either in-person or online. Try talking to friends and family about how you are feeling and stay connected.

You may also benefit from professional support, such as seeing a psychologist or counsellor.

Talk to your doctor if you have ongoing feelings of anxiety or depression.

Life after an amputation

Amputation can affect many areas of your life, including your home and work. It's a lot to adapt to, and you will need support.

You may need modifications to your home, or equipment such as:

• a stair-ramp
• handrails
• a wheelchair lift
• a modified car

You may need to change your routines and find new ways to do the things you are used to doing. The right help, training and equipment will make it easier for you to adapt.

What complications can happen after an amputation?

After an amputation, you may experience some complications, including skin conditions like dermatitis.

Complications can lead to issues with your wound, such as infection. Sometimes, your doctor may need to operate again.

Your doctor can give you advice on how to care for your residual limb to avoid complications.

Contractures

Contractures are when your muscles become shortened and stiff.

Contractures can limit how you move and can make it difficult to fit a prosthesis.

The more you move and exercise after surgery, the less likely you are to develop a contracture.

Your physiotherapist will work with you to keep your joints as mobile as possible.

Phantom pain

You may feel what is known as 'phantom limb'pain. This means you feel pain in the amputated limb, even though it's no longer there.

Some people also have 'phantom sensations', meaning they can still feel the limb that has been removed. You may have sensations such as:

• pins and needles
• itching
• tingling

Phantom limb pain and sensations are common and may last for a few weeks after your amputation. If phantom limb pain persists or is very uncomfortable, speak with your doctor.

Falls risk

After having an amputation, you may have a higher chance of falls. Falls can have an impact on your life, especially if you are aged over 70 years.

To prevent falls:

• your doctor can provide you with aids to help your mobility
• an occupational therapist can review your home and suggest changes to help your mobility and prevent falls
• a physiotherapist can work with you to improve your balance and prevent falls

Are there any alternatives to an amputation?

Before an amputation, your doctor will try to preserve the current function of your limb with treatment.

Alternatives to amputation may depend on what is the problem with your limb. You can ask your doctor about your treatment options.

If you have diabetes or peripheral vascular disease, ask your doctor about revascularisation treatment. The goal of revascularisation is to increase blood flow in the area.

If you have cancer in a limb, a rotationplasty may be an alternative to amputation. This is when the unhealthy part of your limb is removed. The healthy area below this is rotated 180 degrees and reattached.

While this can still be a major change, it's different to an amputation. You may still be able to feel and control your lower limb. You may also avoid pain associated with amputation.

What happens if I decide not to have an amputation?

The decision to have an elective amputation can be very hard.

Your doctor can talk to you about what may happen if you choose to not have an amputation. This may depend on your condition.

Resources and support

Limbs 4 Life offers support and information on prosthetics and recovery to help people who have had an amputation.

Mental health support is available from:

• Lifeline — for crisis support, phone 13 11 14
• SANE Australia — Helpline 1800 187 263
• Beyond Blue — phone 1300 22 4636

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.