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After amputation surgery

 
Three Phases of Recovery copy

A “typical” lower-limb amputation can broadly be divided into three phases, namely the wound healing phase, the mobilisation phase and the reintegration phase. But please remember: every person is unique, and treatment methods differ. This means that the steps we describe may not coincide exactly with your own treatment pathway. 

It’s also very important to remember that the healing time after surgery varies from person to person and the length of your recovery period depends on all kinds of factors, such as the reason for your amputation, your age, health and the rehabilitation protocol followed by your medical team.

The wound healing phase

Following the amputation, treatment will focus first on healing the wound and then on shaping your residual limb. Let’s look at the two objectives of the wound healing phase in more detail:

Wound care

The objective here is simply to make sure that the wound heals. Amputation is major surgery, and your surgeon is actively involved during that stage, assisted by the hospital nursing staff. We recommend a special removable rigid dressing after surgery, as this kind of dressing has been proved to reduce pain, reduce the risk of injury to your residual limb from falls, and shorten wound healing time.

Shaping of the residual limb

When the surgeon is satisfied with how the wound is healing, compression therapy can begin. The aim here is to shape your residual limb, because this has a direct bearing on the successful fitting of a prosthetic leg: a residual limb with an even, uniform shape will present fewer complications when you’re eventually fitted with a prosthetic leg.

Compression therapy traditionally involves the application of an elastic compression bandage over the residual limb in a very specific way, but a far simpler method involves a special silicone sleeve, called a post-operative silicone liner, worn over the residual limb. If your surgeon prefers this treatment, it will be introduced gradually until you’re wearing the silicone liner twice daily for up to four hours at a time.

The mobilisation phase 

As soon as your surgeon feels you’re ready, a physiotherapist will help you mobilise your body with special exercises. Early mobilisation is very important: it has been proved that in general the earlier one is mobilised, the faster recovery happens. At this stage, your residual limb is probably still being shaped with post-operative silicone liners, and you’ll be carefully monitored to see when you’re ready for the reintegration phase. When the wound has healed sufficiently, the surgeon will discharge you from hospital, and you’ll continue the mobilisation exercises until you’re ready for the first fitting of a prosthetic leg.

Under the Self-care tips section we offer some practical advice to help you maintain your mobility.

Good idea

Ask your doctor or prosthetist to refer you to a physiotherapist who specialises in the treatment of people who have had an amputation.

Wayne Derman etch 2"If you do not have the opportunity to get treatment at a specialised rehabilitation centre, ask your doctor or prosthetist to help you develop a rehabilitation plan that utilises the skills of those medical professionals that are available in your area."

- Prof Wayne Derman

The reintegration phase

The goal of the reintegration phase is to restore your mobility and independence as fully as possible. In the next section we explain some key topics, such as what to consider when choosing a prosthetist, what to expect when your prosthetic leg is made, and some psychological considerations.

Working with a team of well-coordinated experts will increase the quality of your care and significantly reduce the duration of your rehabilitation. It is your surgeon’s responsibility to refer you to the right medical professionals for the various aspects of your rehabilitation, based on your physical, psychological and vocational needs. Consulting with a prosthetist is a good way to start on the road to recovery, but you will most likely also need help from other medical professionals, such as a physiotherapist, a biokineticist, a psychologist, an occupational therapist and perhaps even a dietitian.

 

This type of multidisciplinary team is available in specialised rehabilitation centres in some areas, but if you live in a small town or a rural area, there may not be enough patients to support such a facility. If you can, it might be a good idea to invest in your health by commuting to a rehabilitation centre until your independence is restored.