Amputation process: rehabilitation after the amputation

Following the amputation, all attention will be devoted to your recovery and the healing of your residual limb. Both are important for the smooth progress of your rehabilitation after the amputation and for fitting a prosthesis. After the amputation, your residual limb will be covered with a special dressing to enable the wound to heal as thoroughly and quickly as possible. Your doctor’s most important goal is to prepare the residual limb as best as possible for your future prosthesis.

Right after the operation, the focus is on three treatment goals:

• Experiencing little to no pain
• Preparing your residual limb to support weight
• Being able to move your residual limb in all directions as much as possible

To achieve these three goals, it is important that your doctor or physical therapist address a number of important matters immediately after the operation. One of them is the proper way to sit or lie in bed, so that the muscles and joints around your residual limb do not become too rigid. You will also learn which exercises you can do to prepare your body as best as possible for the future. By following the recommendations of your doctor or therapist, you can ensure that you can be fitted for a prosthesis more quickly, which in turn will enable you to be more mobile and active.

Immediately after the operation, you will probably be unable to lie still for long periods of time or even turn in bed. So, the nursing staff at the hospital will help you change position regularly. This is extremely important because it helps you find the perfect position and prevents bedsores. Shifting position regularly also ensures that limitations do not develop in your hip or knee, as this could make your rehabilitation process more difficult.

When the anaesthesia wears off, you’ll find that your amputated body part has been wrapped with simple dressing or a lightweight cast. A surgical drain will also have been placed to drain excess fluid and blood from the wound. Once the drainage has stopped and your wound has healed somewhat, this drain will be removed, after which your wound can heal completely.

It usually takes around three to four weeks for the surgical wound to close. A scar will then form. But even when the scar appears to have healed completely, the healing process still continues. It takes around six months before everything is fully healed under the skin. Right after the operation, it is very important that the wound is cared for intensively. This keeps the scar tissue more flexible and strong, which is of major importance for wearing a prosthesis.

It is normal for the residual limb to swell after the operation. This swelling is a reaction to the operation and will diminish after around a week. To reduce the swelling of the residual limb, residual limb compression is used. This means that, almost immediately after the operation, the residual limb will be wrapped with bandages, compression socks or other compression devices. This residual limb compression ensures that the residual limb heals more quickly and is in good condition for the fitting of a prosthesis. Compression therapy also improves blood circulation in the residual limb, reducing pain and allowing the scar to heal more quickly.

It goes without saying that you want to recover as quickly as possible after the operation. For this reason, it is important that you prepare your body as best as possible for rehabilitation by doing strengthening exercises. Your physical therapist will teach you exercises that promote your recovery, both general exercises and ones specifically designed to strengthen your residual limb. The exercises are intended to prevent your muscles and joints from stiffening. It also takes time to get accustomed to your new body and the movements of your amputated leg.

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Right after the operation, it will still be difficult to sit upright or go from your bed to your wheelchair. Fortunately, with a bit of practice, you will be able to do these things before long. Naturally, your physical therapist will help you with this. It can be helpful to use rails or grab bars next to your bed and wheelchair. When you stand up for the first time after the operation, you will notice that your balance has been affected by the missing limb. So, it is very important that you train your balance. At first, it can be helpful to use a walker or other device.

In some cases, a practice prosthesis will be fitted shortly after the amputation. This lets you quickly get used to the load that is placed on the residual limb and can start your walking training right away. A practice prosthesis is usually fitted around ten days after the amputation. However, it is not suitable for all amputation levels. So, your treatment team will determine whether you are eligible for a practice prosthesis based on your specific situation. If you are eligible, you will be fitted for your practice prosthesis after a few weeks. This prosthesis can be used for standing and walking exercises.

Most people who have undergone an amputation will experience a wide range of emotions. To help with coping and adjustment, we recommend reading about the different phases of this grieving process.