What is Toe Amputation

Toe amputation is a surgical procedure to remove all or part of a toe. You may have this procedure if:

• Tissue in your toe is dying because of poor blood supply.
• You have a severe infection in your toe.

Removing your toe keeps nearby tissue healthy. If the toe is infected, removing it helps to keep the infection from spreading.

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:

• Bleeding.
• Buildup of blood and fluid (hematoma).
• Infection.
• Allergic reactions to medicines.
• Tissue death in the flap of skin (flap necrosis).
• Trouble with healing.
• Minor changes in the way that you walk (your gait).
• Feeling pain in the area that was removed (phantom pain). This is rare.

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• 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 medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given antibiotic medicine to help prevent infection.
• Plan to have someone take you home after the procedure.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• 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).
• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• Your surgeon will mark the area of your toe for removal.
• Your surgeon will make a surgical cut (incision) in your toe.
• The dead tissue and bone will be removed.
• Nerves and vessels will be tied or heated with a special tool to stop bleeding.
• The area will be drained and cleaned.
• If only part of a toe is removed, the remaining part will be covered with a flap of skin.
• The incision will be treated in one of these ways:
  • It will be closed with stitches (sutures).
  • It will be left open to heal if there is an infection.
• The incision area may be packed with gauze and covered with bandages (dressings).
• Tissue samples may be sent to a lab to be examined under a microscope.

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 often until the medicines you were given have worn off.
• Your foot will be raised up high (elevated) to relieve swelling.
• You will be monitored for pain.
• You will be given pain medicines and antibiotics.
• Your health care provider or physical therapist will help you to move around as soon as possible.
• Do not drive for 24 hours if you received a sedative.

Toe Amputation, Care After

These instructions provide you with information on caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, it is common to have some pain. Pain usually improves within a week.

Follow these instructions at home:

Medicines

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

Managing pain, stiffness, and swelling

• If directed, apply ice to the surgical area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Raise (elevate) your foot so it is above the level of your heart. This helps to reduce swelling.
• Try to walk each day.

Incision care

• Follow instructions from your health care provider about how to take care of your cut from surgery (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.
  • If you got stitches (sutures), leave them in place. They may need to stay in place for 2 weeks or longer.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Bathing

• Do not take baths, swim, use a hot tub, or soak your foot until your health care provider approves.
• You may shower unless you were told not to. When you shower, keep your dressing dry.
• If your dressing has been removed, you may wash your skin with warm water and soap.

Driving

• Do not drive for 24 hours if you received a sedative.
• Do not drive or operate heavy machinery while taking prescription pain medicine.

Activity

• Do exercises as told by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

General instructions

• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Ask your health care provider about wearing special shoes or using inserts to support your foot.
• If you have diabetes, keep your blood sugar under control.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a fever.
• Your dressing is soaked with blood.
• Your sutures tear or they separate.
• You have numbness or tingling in your toes or foot.
• Your foot is cool or pale, or it changes color.
• Your pain does not improve after you take your medicine.

Get help right away if:

• You have pain or swelling that gets worse or does not go away.
• You have red streaks on your skin near your toes, foot, or leg.
• You have pain in your calf or behind your knee.
• You have shortness of breath.
• You have chest pain.