The toll that amputation takes, both physically and emotionally, can be a lot to deal with. For those who have undergone an amputation, or will be soon, you may wonder what you can expect after your procedure in terms of post-operative care.
The truth is, no two experiences are exactly alike. The healing process is patient-specific, and some people will react to care differently than others. Not to mention, the level of amputation plays a huge factor as well. With that being said, there are enough similarities with post-op care across the board that we can give you a general idea of what to expect with any level of amputation.
There will be a healing process after the procedure, and during that process, you may decide that getting a prosthesis is the best way to resume your routine post-amputation. If that’s the case, Horizon Orthotic and Prosthetic Experience in Kansas City is ready to assist you. Our staff is committed to providing expert care that’s tailored to your unique needs, and we offer custom-built prosthetic devices (limbs) designed to help you get back to doing the things you love.
Today, we’ll be going over what you can expect for post-op care following your amputation.
During your surgery, your wound may be closed immediately with staples or sutures. It may also be closed at a later date. Again, it’s important to note that each person is different, and your physician will direct your post-op care.
Before closing your wound, your physician and care team will work to reduce the risk of infection and heal the soft tissue beneath the residual limb. This will involve consistent dressing changes and, sometimes, inserting a drainage tube and skeletal pins to improve tissue health and maintain bone alignment.
Here, it’s also imperative on your end to follow the instructions from your care team in order to help your healing process. Once you have your sutures or staples in place, they’ll be covered in some manner. That may be with a cast or splint, or it may be with a compression dressing, such as a petroleum-impregnated gauze covered by a tight bandage.
The goal of these compression dressings is to protect the wound and reduce swelling, while also preparing you for prosthetic fitting. Regardless of what’s used to protect your wound, you must change your dressings multiple times per day. Not only does this maintain proper compression, but it also allows your care team to check the healing progress of the wound.
Usually, HOPE KC is not involved in this stage of the process. However, we have strong relationships with surgeons, nurses, and physical therapists throughout the Kansas City metro area and will assist whenever they recommend it. If you do have any complications or medical issues during this stage, please contact your care team or call 911 in case of emergency.
While still at the hospital, amputees will take an assessment to determine how much physical therapy can be performed. Patients will work with a physical therapist not only to prevent physical issues such as joint-tightening and muscle-shortening, but also to help with a patient’s mental health and decrease anxiety post-surgery.
Physical therapists will teach amputees basic care in the early stages of the process, such as how to safely move the residual limb, how to support it when laying down or sitting, and how to move between two different surfaces.
Following that, the focus will move to other means of physical therapy, including breathing exercises, range of motion exercises (both active and passive), and resistance exercises. When a patient will start their physical therapy depends on several factors, but starting earlier has a greater potential for success.
Again, this is patient-specific, but staples or sutures will usually come out after about three weeks. Once that happens, we can begin preparation for a prosthesis in Kansas City. Once your wound is healed up, you’ll transition from a suture or staple to what’s called a shrinker sock.
The goal of this sock is to apply pressure and reduce swelling in the residual limb. Not only that, the sock helps to shape the limb and fit it for a prosthetic device. . You can either use the shrinker sock on its own, or you can combine it with additional bandaging.
Another option for post-op care for the below-knee amputee involves a limb protector. The purpose of the protector is to help prevent potential damage to the limb in case you fall. In addition, the protector helps keep your knee in full extension. This helps to prevent a knee contracture and ensures a full range of motion is available when the time comes to get your prosthesis. Not every amputee needs a protector, but your physician will decide if this is necessary.
At this point, you’ll have already started performing exercises on your residual limb that will prepare you for your new prosthesis.
These include four different techniques:
You can use these techniques yourself, or you have a physical therapist, family member, or friend perform them on the limb.
Massaging your residual limb early on will help you get used to both touch and pressure, with the goal of helping you build a tolerance to both sensations. It can also help you combat the sensation of phantom limb pain, which occurs because of mixed signals from your brain that your limb is still intact. You massage your residual limb both with and without your compression dressings in place.
When massaging your residual limb, it’s best to do so gently by kneading with one or two hands. Be careful not to press too hard at first, but over time you’ll be able to increase pressure. Each time you should massage your limb at a pressure that you can tolerate. Remember, more is not always better. Do this three or four times per day for about five minutes and be sure to massage the entire residual limb in the process for maximum effectiveness.
Tapping your residual limb early in the healing process also helps accomplish the same goals as massaging. Both help increase tolerance to different sensations, in order to help create a smoother transition to a prosthetic limb. Like massaging, tapping can be done with or without the dressing on the residual limb.
For tapping the residual limb, it’s important to make sure that you’re not tapping with your fingernails. We don’t want to cause any cuts or scratches to the residual limb. Instead, gently tap with your fingertips. It’s also okay to tap above the suture line even before your care team removes the sutures.
As you heal and once your sutures are removed, you can transition to more of a slapping motion with one or two hands. Do your tapping exercises one to two times per day for three to four minutes each time, or more if you find it helpful for reducing phantom pain.
Next up is desensitization, which is used to make your residual limb less sensitive to touching different materials. The idea is to start with a softer material and gradually progress to more rough ones as you develop a tolerance.
Unlike massaging and tapping, you should perform desensitization exercises without a compression dressing on the residual limb. Usually, you’ll do these exercises during bathing times, but you can also do them after.
Start by using a soft material, such as a cotton ball, and rubbing it in a circular motion on the residual limb. As time goes on and you adapt to the sensation, gradually start rubbing the residual limb with rougher materials, such as a paper towel. Eventually, you’ll be able to work your way up to a towel or cloth. Do these exercises two to three times per day for two to three minutes.
The goal of scar mobilization is to ensure that the scar tissue and skin in the residual limb remain loose. If your scar sticks to the underlying tissue in your residual limb, it could lead to pain, blistering, and other issues once an amputee starts wearing a prosthetic limb. Scar mobilization is most effective when performed without your compression dressing and should be done once a day during bathing.
To perform scar mobilization, take two fingers and press firmly on the bony portion of your residual extremity. Then, move your fingers in a circular motion for one minute on that portion before moving on to the rest of the skin and underlying tissue. Once your wound is healed, you can do this exercise directly on your incision scar to loosen and mobilize the scar tissue directly.
Before the staff at HOPE KC take action and begin fitting for your prosthesis, we have to consider where you’re at in the healing process. How each amputee heals is patient-specific, and there will be several factors to consider before we can get involved. Assuming you follow all the steps outlined by your care team and heal according to plan, we can begin our process for equipping you with a prosthesis for your upper or lower body.
The goal of a prosthesis is to help you maintain independence and help you maintain a more active lifestyle. Not everyone chooses a prosthetic limb following an amputation, and that’s okay, too! However, if the prosthesis is your decision and you’ve taken the necessary post-op steps to prepare for an artificial limb, there is a set process that we use at HOPE KC to help find a prosthesis that fits your lifestyle.
We will center your initial visit to HOPE KC around building a relationship with you. Here, we’ll learn more information about your life and hobbies. We do this to not only establish a more personal connection with you, but also so that we can determine what kind of prosthesis will be best for your needs.
After working with you to determine your goals for prosthesis and what type of lifestyle you want to live with an artificial limb, we’ll move on to measurements. This involves a cast or 3-D scan of the residual limb so that we can build a device that’s custom fit for your body.
By this point in your post-op care, you should have more of a tolerance built up in the residual limb, which will allow you to test the artificial limb for the correct fit and functionality. A prosthesis should feel like an extension of your body and not as some awkward obstruction. That’s where a proper socket and suspension system plays a huge role. If these two structures fit well and are in-tune with your body, they’ll allow for maximum comfort and mobility with your prosthesis.
Once we develop a device that fits properly, we’ll deliver it to you and shift our focus to helping you adjust to your new life with a prosthesis. This part of the process is designed to make you feel more comfortable with your artificial limb, while also explaining its day-to-day care and use.
Our service doesn’t end when you walk out the door, however. We’re here with you every step of the way to answer questions or address concerns with your new prosthesis. Not only that, we’ll continue to work with you and other health care providers to ensure that your device is still functioning properly, as well as allowing you to live your desired lifestyle post-operation.
It’s important to remember that your journey may not be as simple as the steps we’ve outlined here. There are several complications that may come up in the time it takes to get your custom prosthesis. You’ll need to be on the lookout for issues with your muscles, joints, and skin.
Muscle weakness, joint instability, and skin infections or blisters can all occur without proper care for your residual limb. That’s not to mention the different pain types that may occur as well, such as wound-site pain or phantom limb pain.
There’s also the psychological aspect of amputation. An injury to the limb and subsequent amputation are both traumatic events for the patient, and it’s important that you’re talking to your care team about any physical and emotional issues you might be facing.
On the emotional side, it’s completely normal to struggle post-amputation. Realize that you aren’t alone and that you can lean on a variety of different resources to help you cope with the trauma. Family, friends, your care team, a support group, or those who’ve dealt with similar injuries are all available to help you overcome the pain and loss you may be feeling.
On the physical side, perform regular inspections of the residual limb so that you can spot any potential skin issues early on. You should also clean your residual limb frequently and consistently change compression dressings in the early stages of post-op care. If or when you get a prosthesis, it’s also important you clean the sockets daily with soap and water or rubbing alcohol.
As you can see, post-op care following amputation contains a lot of information. Even more than what we got into in this post today. It’s no doubt a lengthy process that involves multiple different steps, and it begins almost immediately following surgery.
Even though HOPE KC isn’t always involved in the early stages of care and physical therapy, our relationships with surgeons across the Kansas City metro make us available for assistance at the drop of a hat.
After those initial first few weeks, you may be able to prepare yourself for prosthesis with certain exercises. These include messaging, tapping, desensitization, and scar mobilization. Again, when this stage can begin is all dependent on the patient, how they heal, and where their amputation took place. Post-op care isn’t a one-size-fits-all type of situation and certain people react differently to treatment.
If patients respond well to post-op care, however, HOPE KC can begin the process of finding a custom-fit prosthesis that best suits their needs and goals post-amputation.
When people work with Horizon Orthotic & Prosthetic Experience in Kansas City, they’re working with a professional clinical staff who values relationships and treats people like family.
Our clinical staff is highly trained and strives to make a difference in the lives of others. When a person visits our state-of-the-art facilities, we will evaluate them and custom design the best prosthesis to fit their limb, life, and goals. For convenience, we have six locations spanning across the Kansas City metro area, Central Kansas, and Central Missouri areas.
We are an award-winning, local prosthetic and orthotic company that strives to give our patients HOPE every day.
For more information about custom prosthetics in Kansas City, contact us today.
