Amputation Injuries

What is an Amputation Injury ?

The term “ Amputation” refers to the loss or removal of a body part, most often finger, toe, hand, foot, arm or leg.

Why do Amputation Injuries occur ?

  • > 90% traumatic genesis
  • Less planned amputation. e.g. B. Tumors

They most often happen on the hand > upper limb >lower limb

What Forms of amputation injuries are there?

  • Depending on the amputation level, a distinction is made between macro-amputation and micro-amputation injuries

    • Arm (upper extremity): limit is the radiocarpal joint.
    • Leg (lower extremity): limit is the upper ankle

    Depending on the existing blood flow and the preserved tissue bridge, a distinction is made between:

    • total (complete severance) amputation
    • subtotal amputation
    • complex bone-soft-tissue damage (“mangled extremities”)

    If the blood flow must be restored by vascular anastomosis and gthere is less than 25% preserved soft tissue bridge, a replantation must be carried out the save the amputated part. 

What are the consequences of Skin tear wounds?

Amputation injuries of arms and legs (macro- amputation injuries) are life-threatening injuries.

In general amputation injuries can affecting your ability to move, work, interact with others and maintain your independence. Continuing pain, phantom limb phenomena and emotional trauma can complicate recovery.

How can you treat an amputation injury?

First Aid for amputation Injuries (Emergency treatment)

  • Patient: 
    • Protection of vital functions
  • Amputation stump:
    • Manipulations such as cleaning. Disinfection or setting clamps should be definitive before supply can be avoided
    • Hemostasis of the amputation stump must be done with a pressure bandage at the level of the bleeding. Do not use circular Tourniquets at the basis of the limb.
  • Amputated part: Storage according to the “principle dry principle cooling”
  • Emergency Transport: Attempts at replanting should only be carried out in rooms that are equipped for this purpose facilities (24-hour/365-day replantation service) (consider relocation if necessary).

Specific Management of amputation Injuries

Vascularization after macro- replantation must be restored after 6 hrs, and after microamputation up to 12 hrs.

The basic replantation sequence includes:

    • Wound cleaning, disinfection and debridement
    • osteosynthesis
    • microsurgical restoration of the artery (inflow)
    • microsurgical repair of the veins (outflow)
    • Treatment of muscle and tendon injuries
    • microsurgical restoration of nerve continuity
    • Wound closure and postoperative immobilization

Specific Rehabilitation after Replantation

Replanted body parts need an extensive rehabilitation in order to develop and use the reconstructed functionms.