Acute post-surgical management of the amputee

Original Editor - as part of the WCPT Network for Amputee Rehabilitation Project

Top Contributors - Admin, Tarina van der Stockt, Tony Lowe, Aicha Benyaich, Kim Jackson, Naomi O'Reilly, Sheik Abdul Khadir, Andeela Hafeez, Rucha Gadgil, Olajumoke Ogunleye and Jorge Rodríguez Palomino  

Goals of acute post-surgical rehabilitation

1. Prevent post-operative respiratory complications - as well as the effects of an anaesthetic, patients often have pulmonary co-morbidities. Assess and treat as appropriate, including specific respiratory techniques, and early sit out of bed / mobilisation.
2. Assist in wound management - promote opitimal conditions for good wound management
3. Prevent complications associated with immobility and amputation surgery - potential complications include pressure areas, contractures, and deconditioning.
4. Restore mobility and independence - this includes bed mobility, transfers and promoting mobility with walking aids.
5. Prepare the stump for wearing a prosthesis - the ideal stump is one that is well-healed, has good vascular supply, soft and mobile scars, minimal pain, minimal oedema, a length sufficient for biomechanical leverage but not too long to restrict choices for prosthetic components, and large surface areas for distribution of pressure. While the surgery plays a large part in creating the ideal stump, Physiotherapy is required to maximise chances of achieving this ideal.
6. Assist in pain management techniques - 
7. Assist in planning for discharge home or transfer to a rehabilitation setting - active participation with the patient and multidisciplinary team, on negotiating / defining goals to enable discharge or transfer, and using the techniques described to work towards those goals. This may also include training in advanced mobility with crutches for accessing the home, such as car transfers, stairs, ramps, curbs, minimum required endurance.

Ongoing education forms a large part of these goals.

References

References will automatically be added here, see adding references tutorial.