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Your Guide to Leg Amputation Surgery Information for Patients and Families

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Your Guide to Leg Amputation Surgery Information for Patients and Families Your guide to leg amputation surgery Information for patients and families This booklet is designed to help you prepare for your amputation surgery. It includes general information about: • What to expect from amputation surgery • What to expect while you are in the hospital • What will happen while you are recovering after surgery When is my surgery? Your amputation surgery is scheduled for Date of surgery: __________________________ Time of surgery: __________________________ On that day, please get to the hospital 2 hours before the time of your surgery. Go to the Sullivan Lounge on the 5th floor (take the North elevators in the Cardinal Carter Wing and follow the signs to the Sullivan Lounge). You will check in at the Sullivan Lounge Desk. Could the time change? We may need to reschedule your surgery if there is an emergency. If this happens, we will tell you as soon as possible. Table of contents Understanding your surgery ................................................................................4 What is amputation surgery? ............................................................................4 Why do I need amputation surgery? ...............................................................4 Learning about your surgery .............................................................................6 What type of surgery am I having? ..................................................................7 Preparing for surgery .............................................................................................8 What do I need to do the day before my surgery? .......................................8 What should I bring to hospital? ......................................................................9 Having your surgery .............................................................................................10 What will happen the day of surgery? ..........................................................10 Where can family wait while I am in surgery? .............................................10 Will I have pain after surgery? ........................................................................11 Who is on my health care team? ....................................................................14 How long will I be in the hospital? ................................................................14 Where will I go after I leave the hospital? ....................................................15 When will I see the surgeon again? ...............................................................15 How do I take care of my residual limb? ......................................................15 How should I lie in bed after surgery? ..........................................................16 3 Understanding your surgery What is amputation surgery? An amputation of the lower limb is a kind of surgery to remove a leg or part of it, such as the foot or toe. Amputation surgery takes place in an operating room. The surgery usually takes 1or 2 hours. For the surgery, you will be asleep. You will be given medicine called a general anesthetic. You will get an injection or you will breathe in the medicine through a mask. Once you are asleep the doctor will put a tube in your throat. The tube is attached to a breathing machine to help you breathe during the surgery. Why do I need amputation surgery? Your leg needs to be amputated because you have Peripheral Artery Disease or PAD. When you have PAD, the arteries in your leg are narrow or blocked. This means that your leg is not getting enough blood. The illustration below shows what a narrow artery looks like. The narrowing or blocking of arteries happens over a long time. If you smoke or have diabetes you are more likely to have these blockages. Your doctor is recommending an amputation because the other treatments they have tried have not improved the blood flow to your leg. 4 Source: National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services If you do not have PAD, you may need to have amputation surgery if: • You have a bad infection that has spread and cannot be treated • You have wounds that will not heal • Your limb was seriously injured • Your limb has frostbite or severe burns 5 Learning about your surgery Amputation is a serious operation. To help you keep up your strength and to recover as quickly as possible, it is important to stay as active as possible. You may have strong feelings about losing your leg. You may feel afraid, angry, upset or relieved at this loss. You may need extra time or help to deal with these feelings. If at any time (before or after your surgery) you would like to speak to someone about these feelings, please let your health care team know. They will be here to help you. If you have any religious beliefs about having a leg amputation, please talk to your surgeon before the surgery. 6 What type of surgery am I having? Your vascular surgery team will talk to you about why you need an amputation. There are 5 types of leg amputation surgeries. Your vascular surgery team will talk to you about which option is best for you. They will explain the risks of the surgery and what could happen if you do not have the surgery. Here is what each type of amputation surgery means: A. Hip disarticulation The leg is cut off (amputated) at the hip joint. The entire leg is removed. B. Above the knee The leg is amputated between the hip and the knee. The amputation can be anywhere between these 2 joints. C. Through knee amputation The leg is amputated at the knee. The only part that is removed is below your knee. D. Below the knee amputation The leg is amputated between the knee and the ankle. The amputation can be anywhere between these 2 joints. E. Foot amputation Only the foot, or part of the foot, is amputated. There are 3 kinds of foot amputations: • Syme amputation (the foot is removed at the ankle) • Forefoot (or transmetatarsal) amputation (only the front part of the foot is removed) • Toe amputation (one or more toes are removed) 7 Preparing for surgery Before your surgery we will meet with you to explain the surgery. We will also do tests to check that surgery is safe for you. These tests and meetings may take place 1 or 2 weeks before the surgery, at the Pre- Admission Facility or after you have been admitted to the hospital. The tests you need include blood work, an ECG (electrocardiogram) and a chest x-ray. We may ask you to have other tests. Your vascular team will explain these to you. Here are the meetings you will have: • A nurse will take your health history, ask what medicines you take and explain what to expect while you are in the hospital. • An anesthesiologist (doctor who puts you to sleep) will go over the types of medicines used during your surgery. • Your vascular surgery team will talk with you. Then they will ask you to sign a consent form for the surgery. What do I need to do the day before my surgery? I have followed the pre-op instructions for the day before and the morning of surgery: c I used the chlorhexidine soap to shower. This is to help prevent infection after surgery. You can buy the chlorhexidine soap at any pharmacy. c I washed my leg with chlorhexidine soap the night before surgery and the morning of surgery. c After my shower I did not use any lotion or cream on my skin. c I have not eaten or had anything to drink after midnight the night before the surgery. c I know which medicines to take the day of surgery. 8 c I have taken my medicines with only sips of water. What should I bring to hospital? You will be in the hospital for a few days, so you will need to bring some things with you. Please bring: • Your Ontario Health Card • Your Hospital Identification Card (if you have one already) • All of your medicines in their original bottles • Loose-fitting clothes • Non-slip slippers or shoes. Choose ones that are easy to put on • Basic toiletries (tooth brush, toothpaste, hair brush) • Personal items such as your dentures, hearing aids and glasses Do not bring the following items to the hospital: • Valuables such as your wallet, jewelry, expensive clothing or large amounts of cash • Scented personal care products • Personal electronics such as cell phones or tablets St. Michael’s is not responsible for lost, stolen or damaged property. 9 Having your surgery What will happen the day of surgery? If you are coming from home, go to the Sullivan Lounge on the 5th floor of the Cardinal Carter Wing. Please arrive 2 hours before your surgery. You will check in at the Sullivan Lounge desk and wait to be called in to the surgical admission unit. A team of surgical nurses will help you get ready for surgery. You will: • Change into a hospital gown • Get an IV (intravenous) in your arm. The IV is used to give you fluids and medicines during and after surgery. Then you will wait in an area called the Holding Area. When it is time for your surgery, you will be taken to the operating room. Where can family wait while I am in surgery? Your family can wait in the Sullivan Lounge on the 5th floor. When your surgery is over, the vascular surgery team will talk to your family. If your family is in the waiting room, they will talk in person. If your family will not be at the hospital, tell your surgeon’s office how to reach them. 10 Recovering from surgery Will I have pain after surgery? You may feel different kinds of pain. You may feel: • Residual limb or incisional pain: This is pain around the area where the skin was cut during surgery. • Phantom sensation: This is the feeling that the missing leg is still there. You may feel tingling, pressure, itching or tickling in the part of your leg that has been removed. • Nerve or neuropathic pain: This is the feeling of pain in the stump or missing leg. You may feel squeezing, shooting, burning, stabbing pain. It is common to have phantom sensation and nerve pain if you had a lot of pain before surgery. Your health care team will help manage your pain.
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