Your initial recovery will happen at the acute care hospital or surgical center where the surgery took place.
Your surgeon will determine the best post-operative dressing for healing. This usually includes soft dressing, such as gauze and pressure wrap (Ace bandage). Occasionally a rigid or semi-rigid material, such as plaster splints, are used; however, these are used less frequently because they make it difficult to access the limb for wound observation.
Your medical team will work with you to get you up and moving soon after surgery to prevent complications, such as blood clots, fluid building up in the lungs, or pressure sores.
You may be referred to a physiatrist, a physical medicine and rehabilitation specialist, to manage your rehabilitation needs. This is likely if you need complete rehabilitation in a specialized rehabilitation facility, such as Mary Free Bed.
Therapy and Rehabilitation
Once you’ve come through your initial recovery from surgery, physical and occupational therapists work with you and your caregivers so you can learn to manage independently.
You may be able to complete therapy at your acute care hospital and go directly home. If you have an upper-limb amputation, you may be able to go home from the acute care hospital.
If you undergo a major lower-limb amputation, you may need to be transferred to a more comprehensive inpatient rehabilitation center, such as Mary Free Bed Rehabilitation Hospital.
Your rehabilitation will teach you new skills. You’ll learn to transfer from a wheelchair to the bed and back again, how to use a wheelchair, and how to use an assistive device, such as a walker or crutches.
Various exercises will strengthen your upper body and help you maintain flexibility and movement in your amputated leg.
After your amputation, you may need to use a wheelchair occasionally to remain mobile. Sometimes, using a wheelchair is best for your mobility.
A shrinker may be applied to your limb to help control swelling, facilitate circulation, and begin to shape the limb for prosthetic fitting.
Most inpatient amputees at Mary Free Bed are at our facility for 10-14 days. Your stay depends on other medical problems you may have, such as high blood pressure, heart problems, or diabetes.
Ideally, your rehabilitation team includes a physician, nurse, physical and/or occupational therapist, and prosthetist. Your rehab experts will help you adapt to life with your amputated limb and help you deal with changes that occur throughout the aging process.
If you’re a candidate to use a prosthesis, your rehab experts:
Prepare you for the prosthesis
Fit you with the prosthesis
Train you to use the prosthesis
Provide problem solving and adjustments
For comprehensive management of your issues, both before and after amputation, Mary Free Bed’s Amputee Clinic provides you a rehab team comprised of a physiatrist, rehabilitation nurse, physical therapist, occupational therapist, and prosthetist.
General complications associated with any major surgery include chest infections, angina, heart attacks, and strokes.
Because your mobility is restricted after your amputation, pressure sores can develop. The nursing staff works hard to prevent sores. You may need a special mattress and bed to reduce pressure on areas at risk for sores. You will be regulary turned to relieve pressure.
Therapy is prescribed as early as feasible to help you restore mobility so you can reduce the risk of complications.
Local complications include wound infections that develop in your residual limb. At the time of surgery, antibiotics may be administered to reduce your risk of infection.
Your residual limb may fail to heal or breakdown as a result of a fall, infection, or poor blood supply. If this happens, you may need an additional surgery to revise your amputation or to remove more of your limb.
Sometimes contractures develop in your knee or hip joint, causing you to experience tight muscles and limited movement in your joint. Once a contracture is present it can be impossible to correct. If your knee or hip won’t straighten, you can’t be fitted for an artificial limb.
Participating in physical therapy and learning proper stretching and exercises before and/or after surgery helps significantly reduce the risk of contracture.
Blood clots can occur in the leg. Blood thinners may be given to reduce the risk of developing blood clots.
Adherent scar tissue can be a source of discomfort as well. A therapist with skills in mobilization of these tissues will help to reduce the risk of this complication.