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Amputation - traumatic

Contents of this page:

Illustrations

Amputation repair
Amputation repair

Alternative Names    Return to top

Loss of a body part

Definition    Return to top

Traumatic amputation is the loss of a body part -- usually a finger, toe, arm, or leg -- that occurs as the result of an accident or trauma.

Considerations    Return to top

If an accident or trauma results in complete amputation (the body part is totally severed), the part sometimes can be reattached, especially when proper care is taken of the severed part and stump.

In a partial amputation, some soft-tissue connection remains. Depending on the severity of the injury, the partially severed extremity may or may not be able to be reattached.

There are various complications associated with amputation of a body part. The most important of these are bleeding, shock, and infection. See also: Wounds

The long-term outcome for amputees has improved due to better understanding of the management of traumatic amputation, early emergency and critical care management, new surgical techniques, early rehabilitation, and new prosthetic designs. New limb replantation techniques have been moderately successful, but incomplete nerve regeneration remains a major limiting factor.

Often, the patient will have a better outcome from having a well-fitting, functional prosthesis than a nonfunctional replanted limb.

Causes    Return to top

Traumatic amputations usually result directly from factory, farm, or power tool accidents or from motor vehicle accidents. Natural disasters, war, and terrorist attacks can also cause traumatic amputations.

Symptoms    Return to top

First Aid    Return to top

  1. Check the person's airway (open if necessary); check breathing and circulation. If necessary, begin rescue breathing, CPR,or bleeding control.
  2. Try to calm and reassure the person as much as possible. Amputation is painful and extremely frightening.
  3. Control bleeding by applying direct pressure to the wound, by elevating the injured area, and, if necessary, by using pressure point bleeding control. If the bleeding continues, recheck the source of the bleeding and reapply direct pressure, with help from someone who is not fatigued. If the person is suffering from life-threatening bleeding, a constriction bandage or tourniquet will be easier to use than compression of pressure points.
  4. Save any severed body parts and ensure that they stay with the patient. Remove contaminating material if possible, and gently rinse the body part if the cut end is contaminated with dirt. Wrap the severed part in a clean, damp cloth, place it in a sealed plastic bag and immerse the bag in cold water (ice water if available). Do not directly immerse the part in water and don't put the severed part directly on ice. Do not use dry ice as this will cause frostbite and injury to the part. If cold water is not available, keep the part away from heat as much as possible. Save it for the medical team, or take it to the hospital. Cooling the severed part will keep it viable for about 18 hours. Without cooling, it will only remain useable for about 4 to 6 hours.
  5. Take steps to prevent shock. Lay the person flat, raise the feet about 12 inches, and cover the person with a coat or blanket. DO NOT place the person in this position if a head, neck, back or leg injury is suspected or if it makes the victim uncomfortable.
  6. Once the bleeding at the site of the amputation is under control, examine the person for other signs of injury that require emergency treatment. Treat fractures, additional cuts, and other injuries appropriately.
  7. Stay with the person until medical help arrives.

DO NOT    Return to top

When to Contact a Medical Professional    Return to top

If someone severs a limb, finger, toe, or other body part, you should call immediately for emergency medical help.

Prevention    Return to top

Use safety equipment when using factory, farm, or power tools. Wear seat belts when driving a motor vehicle. Always use good judgment and observe appropriate safety precautions.

References    Return to top

Woolfrey KGH, Eisenhauer MA. Wrist and Forearm. In: Marx J, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. St Philadelphia, Pa: Mosby Elsevier; 2006:chap 48.

Update Date: 7/29/2008

Updated by: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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