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Below and Above the Knee Amputations What you Need to Know about Limb Loss (4887)

Below and Above the Knee Amputations What you Need to Know about Limb Loss (4887) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, PVS

4887



Below and Above the Knee Amputations
What You Need to Know about Limb Loss

This handout will tell you how to take care
of yourself at home after your Below the
Knee Amputation (BKA) or Above the Knee
Amputation (AKA). Your nurse will review
this sheet with you before you go home.

When to Call Your Doctor

When you do your dressing change daily,
look at your incision site for signs of
infection or breakdown. Call your doctor if
you have these signs of infection or skin
breakdown.

 An increase in redness at the site or red
streaks on your skin that extend from the
site.
 Increased warmth around the site.
 Increased pain that becomes constant or
tenderness around the site.
 Bulging or swelling at the site.
 New drainage or bleeding from your site
(drainage may be cloudy, yellow, or
foul-smelling).
 Open spots between the stitches where
the skin is pulling apart (dehiscence).
 A temperature of more than 101.5 θ F
(38.5 θ C), by mouth; taken twice 4 hours
apart.
 If you notice the skin along the site is
getting darker or turning black.

With these symptoms you should contact
a doctor right away (go to the emergency
room if your doctor cannot be reached).
 Sudden increase in pain that is not
controlled by your pain medicine.
 Uncontrollable bleeding from incision or
anywhere else.
 Sudden increase in tenderness or
swelling in leg.
 Sudden increase in redness, warmth, or
even a bluish skin discoloration in leg.
 Chest pain, shortness of breath, a rapid
pulse and/or rapid breathing.

Care of the Incision

1. Look at your entire leg, front and back,
each day. Use a mirror to look for skin
abrasions, blisters, or red marks. Do not
pop blisters!
2. Wash your leg and incision everyday. It
is very important to keep the leg clean.
 Do not soak the leg.
 Use warm water.
 Use mild soaps without fragrance
(Example: Dial® soap).

3. Apply a telfa to the incision and secure
with paper tape.
4. Wear ace wraps or a shrinker sock at all
times. If you are using ace wraps,
rewrap every 2-4 hours while awake, to
compress the stump. Make sure there
are no creases. Wear a leg protector
(rigid removable dressing) as instructed
by your physical therapist.
 This will help to reduce swelling to
speed up healing and to shape the
stump in preparation for a prosthesis.


Activity

Your doctor would like you to keep doing
your exercises the way you learned in
Physical and Occupational Therapy. You
may notice that you tire quickly as you do
more. This is normal. It should lessen as
you get your strength and energy back. Take
rest periods as needed but be as active as
you can be to maintain your strength.
Activity and exercise are important in
preparing for you prosthesis and keeping
muscle.

Pain Control

It is normal to have pain at the incision site.
Your doctor may have prescribed pain
medicine for you to use at home. Your pain
should lessen over time and may be
managed with something you can buy over-
the-counter. Be sure to ask your doctor
which is best for you.

You may also have one or both of the
problems listed here.

 Phantom sensation is the feeling
that you still have the amputated part
(leg or toe). Often, only the farthest
part is felt, and although not painful,
there may be tingling, numbness, or
pressure. It may disappear as you get
stronger, or it may last throughout
life. Almost all people who have had
an amputation have phantom
sensation.
 Phantom pain is actual pain (most
often the burning, cramping,
squeezing, or shooting type) in the
amputated part. It may be present all
the time or it may come and go.
Phantom pain may be relieved with
pain medicine. If severe phantom
pain is a problem for you, talk to
your doctor about something else for
pain relief. Many people report they
have more relief from the medicine
called Neurontin, which your doctor
can discuss with you.
 (Please refer to Health Facts For
You: Neuropathic Pain)

Diet

You may resume your regular diet when you
return home. You should avoid constipation
Decreased activity as well as some
prescription pain medicines can cause
constipation.
You can try to prevent constipation by
trying these methods:
 Eat foods high in fiber (whole grain
breads and cereals, fresh fruit and
vegetables)
 (Please refer to Health Facts for
You: Constipation).
If these do not work, an over-the-counter
stool softener or laxative (something that
loosens and softens bowels) may be used. If
the problems do not go away, call your
doctor.

Care of Your Other Leg

If you have diabetes or have peripheral
vascular disease, it is important to take good
care of your other leg and foot and protect it
from injury.

Ways to care for other leg:
 Look at legs and feet daily for sores,
scratches, cracks, blisters or
reddened areas. Report them to your
doctor or nurse.
 Wash your legs and feet daily with
mild soap and water. Avoid soaking.
Dry well.
 Put lotion on dry skin daily. Do not
put lotion between your toes.
 Let a doctor or nurse clip your
toenails or show you how to clip
toenails.
 Wear shoes that fit well.
 Wear white cotton or wool socks.
 Check shoes and socks for stones,

sharp things, or holes.
 Do not use heating pads or hot water
bottles on legs or feet.
 Never go barefoot.
 Ask for a mirror if you are not able
to see your foot.
Are You at Risk for Poor Blood Flow to
the Legs and Feet?

You are more likely to have poor blood flow
to the legs if you:
 Smoke
 Have high blood pressure
 Have high cholesterol
 Have diabetes
 Are over age 50
 Do not exercise
 Have heart disease in your family



Phone Numbers

Peripheral Vascular Surgery (PVS) clinic at (608) 263-0186

After hours, call paging at (608) 263-6400. Ask for the vascular surgery physician on call.
Leave your name and phone number with the area code. The doctor will call you back.

If you live out of the area, call 1-800-323-8942.







References

Constipation - www.medicinenet.com

Fahey, Victoria A. 4th ed. Vascular Nursing. Philadelphia: WB Saunders Co., 2003













Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 8/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#4887.