The thought of having to surgically remove a part of the body, such as an arm, a leg, or a finger, can be frightening. It's hard to imagine. But sometimes, to save someone's life or stop a serious infection from spreading, you have to make this difficult decision. Since this is a very sensitive topic, let's talk about it in detail and simply.
What is an 'amputation'?
Simply put, amputation is the surgical removal of a body part, especially an arm, leg, hand, or foot. Sometimes, after a severe accident, a body part is lost, and this surgery is also necessary to clean and safely repair the part.
The parts that are most often removed are:
- A hand or part of a hand
- Palm
- A finger
- A leg or part of a leg
- A foot
- A toe
In addition to these, although very rarely, this may also include the removal of parts of the face (ears, nose, tongue), a breast (mastectomy), testicles, or penis.
Why remove a body part like this?
Imagine, if a branch of a tree dies and rots, it can harm other branches and the whole tree. That's why we cut that branch off and remove it. It's like that. If a body part that has been damaged by a serious illness or a serious accident cannot be restored , keeping it in the body becomes dangerous.
There are several reasons for that:
- Tissue Death: When blood flow to an area is cut off, tissue begins to die. This dead tissue can allow germs to spread throughout the body and become life-threatening.
- Uncontrollable infections: Some infections cannot be controlled no matter how much treatment is given. To stop the infection from spreading to other healthy parts, the infected part must be removed.
- Loss of function: If the nerves in that area are damaged, there will be a loss of sensation and the inability to move properly. When there is a loss of sensation, the injury may go unnoticed and the condition may worsen.
Simply put, this is done to preserve the remaining body, which means saving life. It also allows for the removal of a non-functional part and the replacement with a more useful and better-looking prosthetic part .
What are the main reasons for removing a body part?
Below are some of the main medical conditions and reasons that lead to making such a decision.
| Cause | Simple explanation |
|---|---|
| Peripheral Artery Disease (PAD) | Blockage of blood vessels in the limbs causes blood flow to stop and tissue death. |
| Complications of Diabetes | Diabetes damages the nerves and causes loss of sensation in the feet. This can lead to wounds going unnoticed, becoming infected, and not healing. |
| Gangrene | When blood flow stops, the tissue dies, turns black, and rots, spreading throughout the body. |
| Severe Injuries | An arm or leg is crushed, severed, and irreparably damaged due to car accidents, being caught in machinery, or severe burns. |
| Cancerous Tumors | Cancerous tumors in the bones or muscles cannot be safely removed without removing the part. |
| Life-threatening infections | Severe infections that have spread to the bones, joints, or other tissues and cannot be controlled by antibiotics. |
What happens before surgery?
Unless the surgery is due to an accident, there are several steps you can take to prepare before the surgery.
Assessment
Your medical team will carefully evaluate your condition or the nature of the injury. Sometimes, advanced surgical techniques may be used to try to save the limb. This is called limb salvage surgery . If this is an option, your doctor will discuss the pros and cons with you. But if it is not possible, they will use this assessment to plan the surgery.
Counseling
This is not just surgery. This is a lifelong mental and physical journey. So your medical team will include not only surgeons, but also other specialists. You will meet with various therapists to prepare you for surgery and plan your recovery afterward. If you are interested in a prosthetic limb, you can meet with a prosthetist to discuss your options.
What happens during surgery?
During surgery, the surgeon removes all diseased and damaged tissue. He also tries to save as much healthy tissue as possible. He may also need to repair damaged nerves and blood vessels. The ends of the bone are trimmed or smoothed. The remaining muscle is then attached to the bone and sewn back together. This strengthens the area.
Sometimes, to prepare you for a specific prosthesis, you may need to take additional steps during surgery. For example:
- Target Muscle Reinnervation: This is a very interesting technique. It is especially important for people who have had a hand amputated. The surgeon reconnects the nerves that controlled the movements of your amputated hand to another 'target muscle' in your chest or shoulder. You can then activate that muscle and control the prosthetic hand as you wish.
- Osseointegration: This is where your prosthesis is directly connected to the bone. The surgeon implants a metal anchor into the bone. The prosthesis can be attached directly to it. This makes it very easy to remove and reattach the prosthesis.
- Rotationplasty: This is a very rare surgery. Here, part of the upper leg is removed and the healthy lower leg is reattached as the upper leg. But rotated. This makes your ankle joint act like a knee. This allows you to use a below-the-knee prosthesis instead of an above-the-knee prosthesis.
What happens after surgery?
After surgery, you will need to stay in the hospital for a few days or weeks. You will be given oxygen, saline (IV), and pain medication as needed. You may have a urinary catheter inserted. A physical therapist will come in a few days and start you on small exercises to help relieve stiffness.
After that, you will need to continue your rehabilitation process at home or in a specialized rehabilitation center. During this time, various specialists will help you learn to live with your changed body.
Your rehabilitation program may include:
- Physical Therapy: You need to move regularly to prevent tissue stiffness. You also need to learn to use your body in new ways and rely on different muscles.
- Occupational Therapy: An occupational therapist helps you learn to do everyday tasks (housework, work) in a way that suits your new body.
- Psychotherapy: This is very important. Losing a body part is a major psychological trauma. It is very important to seek professional help to deal with the range of emotions (sadness, anger, fear) that come with it and to help you adjust your thoughts.
- Fitting and training for a prosthetic leg: If you are planning to use a prosthetic leg, the process of fitting it will begin after the wound has healed. Then you will need to train to use it for several months.
How long will it take to heal? How is the pain?
Recovery time varies from person to person. Typically, it takes about two to three months for the surgical wounds to heal and the swelling to go down. Only then can a prosthetic limb be fitted. Physical therapy begins as soon as possible after surgery and should continue for at least six months.
Speaking of pain, you won't feel any pain during the surgery. After that, you'll be given strong painkillers in the hospital. However, other types of pain may occur in the long term.
- Residual Limb Pain: Pain may occur in the stump of the limb that was removed. This nerve pain can be caused by damage to the nerves during surgery. There may also be skin problems caused by the prosthesis. Talk to your doctor or prosthetics specialist about this.
- Phantom Limb Pain: Many people feel as if their amputated limb is still there and is causing pain. This is very common. This is because the severed nerves are still sending signals to the brain. This is normal, so talk to your doctor about this.
- Psychological Pain: The psychological stress, grief, and trauma caused by losing a body part is immense. This can lead to conditions like depression or post-traumatic stress disorder (PTSD). It is essential to seek professional help to cope with this psychological pain.
When should you contact your medical team?
During your recovery, if you experience any problems or discomfort, contact your medical team immediately. They are here to help you.
| Who do you want to talk to? | When/on what occasion? |
|---|---|
| To the surgeon | If the wound does not seem to be healing, if the wound gets worse, or if new symptoms such as fever appear. |
| To the Physical Therapist | If there is stiffness in the body, difficulty moving, or pain due to overuse of one side of the body. |
| For the mental health professional | If you need mental or emotional support, counseling, or medication. |
| To the Prosthetist | If your prosthesis causes discomfort to the skin on the remaining area or if it does not fit properly. |
Removing a body part is not a decision that you or your doctor should take lightly. But if an accident or illness threatens your life, you may have to sacrifice that part for the sake of your overall health. It's not easy, but this surgery can free you from a life-threatening condition. It will take time to adjust physically and mentally. But with the right support and rehabilitation, you can regain your mobility, independence, and love of life.
Take-Home Message
- Amputation is a necessary medical decision, often to save a life. Don't think of it as a defeat.
- The healing process is a journey that is both physical and mental. You will have the support of a full team of doctors, therapists, and others.
- Mental health is just as important as physical health. Never be afraid to seek mental health support.
- With the right rehabilitation, support, and a positive attitude, it is entirely possible to live a full, active, and fulfilling life even after losing a body part.
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