AMPUTATIONS large blood vessels.

The squeezing
Objectives: helps stop blood loss. This device is
- Definition of amputation used just above where they’re going
- Statistics to cut.
- Reason for amputation
- Types of amputation
- Psychological support preparation
- Types of surgery, pre-op, and post-
op care b. Used to cut the legs off, and bones.
- Surgical complications
- Amputation complications
- Stump care
- Rehabilitation and prosthesis
- Case study and question
Background c. Used to cut the muscles
- In the past, amputation involve
rapidly cutting the limb.
- Hemostasis achieved by crushing or
using boiling oil
- AMBROISE PARE- created more
functional stump
o First use
o Primitive
d. Forceps to cut he arteries, and
Instruments that are traditionally used in needs ligatures to tie them up
amputation.
Why are there many amputations way back
time? Because long ago they do not have
any idea about germs, sterile methods, and
anesthesia.
In today’s time- we have antibiotics to
prevent infection by gas gangrene

Long ago – surgeons would spit on your

limb or put boiling water and pour it on the
stump so that it would burn off the bleeding
arteries and veins, to hopefully survives

Amputation
- the intentional surgical removal or a
limb or body part through one or
more bones.
a. Tourniquet- is a device that is
placed around a bleeding arm or - It is performed to remove diseased
leg. Tourniquets work by squeezing tissue or relieve pain
- Uses bone saw
 - Cold to touch
Disarticulation - Cyanosis
- Removes a part through a joint - Usually seen in smokers
- Does not need bone saw - Buerger’s disease
- Faster
- Cut off the Skin  subcutaneous
tissue  muscles  ligate the
nerves and blood vessels
- Cut of all soft tissue through the joint
- For patient that does not really need
prosthesis
- Preferably for pediatric patient 
bone growth; Overgrowth in the
stump is not so much
STATISTICS
- Lower limb amputations are 4 times Infection
more common than upper limbs - Diabetic patient
(infection)  Diabetes Mellitus/ - (+) pressure sore
arterial disease/ peripheral vascular - Negros occidental = highest infection
disease rate  since we are the sugar
- 90% of amputations caused by capital
vascular disease involve the lower
limb  poor blood supply = faster
infection rates
- 70% of amputations caused by
trauma involve the upper limb (?)
- Limb amputations are resulting from
cancer that are commonly involved
the lower limb
CAUSATIVE FACTORS OF AMPUTATION
- Peripheral arterial disease – MC
o Poor blood supply Trauma
o Poor healing Questions:
o Poor immune response to - Is this irreparable?
infection - Is the blood supply ok?
o Poor sensation - Is the nerve supply ok?
- Diabetes mellitus - LIMB salvage vs Amputation
o Neuropathy = poor BS in
nerve
- Gangrene
o Gas gangrene (seldom)
- Trauma (crushing, frost bite, burns,
electrocution)
- Congenital amputations
- Chronic osteomyelitis – infection
of the bone Congenital Anomalies
- Malignant tumor

Arterial disease
- Constricting band – cuts off the
circulation once an extremity
inflames, strangulate the whole limb
 limb dies; solution  take out the
band by doing certain type of
incision to take out the congenital
band

Malignancy
- There are some tumors that you
could save and there are some that
you couldn’t