What is Leg Amputation

Leg amputation is a procedure to remove the leg. You may have this procedure if your leg has been affected by a disease, such as peripheral artery disease or severe circulation disease, and is causing problems. There are three types of leg amputation:

• Above-the-knee amputation (transfemoral amputation). This type is done to remove the leg from above the knee.
• Below-the-knee amputation (transtibial amputation). This type is done to remove the leg from below the knee.
• Through-knee amputation. This type is done to remove the leg at the knee joint.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Stiffening of the hip and knee joint (hip and knee contracture).
• Blood clot in a deep vein (deep vein thrombosis, orDVT), usually in the leg.
• A blood clot in your lung (pulmonary embolism).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• You may be given antibiotic medicine to help prevent an infection. If so, take the antibiotic as told by your health care provider.

General instructions

• Ask your health care provider how your surgical site will be marked or identified.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
• Damaged or diseased tissue and bone will be removed.
• Uneven areas of bone will be smoothed.
• Blood vessels and nerves will be closed off.
• Muscles will be cut and reshaped so that an artificial leg (prosthesis) can be attached to the stump.
• The incision will be closed with stitches (sutures).
• A bandage (dressing) will be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be given medicine for pain. The medicine may include:
  • A sedative.
  • A spinal anesthetic.
  • A regional anesthetic.
• You may start physical therapy within 24 hours after your surgery.

Summary

• Leg amputation is a procedure to remove the leg from above, below, or through the knee.
• Follow instructions from your health care provider about eating or drinking restrictions before the procedure.
• Before the procedure, ask your health care provider how your surgical site will be marked or identified.

Leg Amputation, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• A little blood or fluid coming from your incision.
• Pain from your incision.
• Pain that feels like it is coming from the leg that has been removed (phantom pain). This can last for a year or longer.
• Skin breakdown on your stump (residual limb).
• Feelings of depression, anxiety, and fear.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Bathing

• Do not take baths, swim, use a hot tub, or get your residual limb wet until your health care provider approves. You may only be allowed to take sponge baths.
• Ask your health care provider when you may start taking showers. After taking a shower, make sure to rinse and dry your residual limb carefully.

Incision care

• Check your residual limb, especially your incision area, every day. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
  • Blisters.
  • Scrapes.
• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do physical therapy exercises as told by your health care provider.
• If you have been fitted with an artificial leg (prosthesis) or have been given crutches, use them as told by your health care provider.

Eating and drinking

• Eat a healthy diet that includes whole grains, fruits and vegetables, low-fat dairy products, and lean proteins.
• Drink enough fluid to keep your urine pale yellow.

Driving

• Work with an occupational therapist to learn new strategies for safe driving with an amputation.
• Do not drive or use heavy equipment while taking prescription pain medicine.

General instructions

• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Do not use oils, lotion, cream, or rubbing alcohol on the remaining part of your leg.
• Wear compression stockings as told by your health care provider.
• If you have trouble coping with your amputation, contact your health care provider. Some feelings of depression, anxiety, or fear are normal after an amputation, but if you struggle with these feelings or if they get overwhelming, your provider may be able to recommend a therapist or support group to help you.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• You have more tenderness in your residual limb.
• You have a rash or itchy skin.
• You have a cough or chills and you feel achy and weak.
• You have trouble coping with your amputation.
• You have blisters or scrapes on your residual limb.

Get help right away if:

• You have severe pain in your residual limb.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch, tender, and painful.
• You have pus or a bad smell coming from your incision.
• You feel light-headed and have shortness of breath.
• You have blood-soaked bandages.
• You cough up blood.
• You have chest pain or pain when taking a deep breath or coughing. If you have these symptoms, do not drive yourself to the hospital. Call emergency services right away.

If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to your nearest emergency department or call:

• Your local emergency services (911 in the U.S.).
• A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

• After a leg amputation, you may have pain that feels like it is coming from the leg that was removed (phantom pain). This can last for a year or longer.
• Follow instructions from your health care provider about how to take care of your incision.
• Check your residual limb, especially your incision area, every day. More redness, swelling, or pain may be a sign of infection.
• Contact your health care provider if you have trouble coping with your amputation.