There are many health issues that can affect amputees both in the early days of recovery and further down the road. Many of these issues can be managed proactively, before they occur. Health care professionals need to be vigilant for such complications. In addition, the patient needs to be aware of the potential for these complications to occur and when to notify their physician. The following outlines some of the potential health issues that may affect patients and some preventative measures which can be undertaken to avoid them.

Phantom Pain

Phantom limb pain is discomfort felt by the amputee to be arising from the amputated limb. It may be described as pain, a burning or itching sensation, or other unpleasant sensation. The pain is very real, and can be debilitating for some patients. There is research that has found that adequately treating pain in the postoperative period can reduce the risk of phantom pain. When phantom pain does occur, pain medications and medications for the treatment of nerve pain may be tried. Other methods that may be helpful in controlling phantom pain include hypnotherapy, biofeedback, and other therapies designed to alter the patient’s perception of the pain.

Contractures

Contractures, or shortening of the muscles, may occur after prolonged bed rest or prolonged sitting, as in a wheelchair. Contractures are one of the reasons that rehabilitation is commenced so soon after surgery, sometimes within 48 hours depending on the patient. Contractures are important to avoid because they  make fitting a prosthesis more difficult.

Death of the Skin Flaps

Tissue necrosis, or death of the tissue that make up the skin flaps, can sometimes occur if circulation to the skin is inadequate. This may necessitate repeat surgery. To help avoid this complication, the patient can begin gently mobilizing the stump immediately after surgery to promote circulation to the area.

Wound Opening

Wound opening can occur due to an infection, excess swelling in the stump, or too much tension on the sutures used to close the wound. Obviously, wound opening will delay healing. Use of elastic garments (bandages), stump socks, and shrinkers may help protect the stump from this complication. Antibiotics are given in the postoperative period to decrease the risk of infection.

Failure to Heal

Occasionally, stumps may fail to heal properly. This may be due to poor physical health of the patient, such as diabetes, or to poor nutritional status. It may be a sign of infection in the stump. It may be due to poor circulation to the area. This complication may require further surgery.

Infection

Infection in the stump must be regarded seriously, as infection will impede wound healing. Antibiotics are often started before the amputation and continued for a period of time after the surgery. Signs of infection may include fever, drainage, and a foul wound odor.

Depression

Depression may start immediately after surgery or later, after the patient has gone home. Patients should be encouraged to talk about their feelings with a professional. Physicians should be vigilant for signs and symptoms of depression and question the patient who appears depressed. Depression is very common but should never be minimized.

Weight Gain

Many amputees gain weight after amputation due to a more sedentary lifestyle. Patients who are depressed may gain weight if eating is a comfort. Amputees may not feel comfortable exercising in public. Weight gain can be a problem if it hinders mobilization.

Prosthetic Complications

Poorly fitting prosthetics may lead to redness, skin breakdown, bruising, or blister formation on the stump. It is important that amputees regularly examine their stump for any signs of irritation. They should also have their prosthesis evaluated by a professional every 6 months to a year, or as recommended by their doctor.