Below The Knee Amputation

WHAT YOU SHOULD KNOW:

Below The Knee Amputation (Discharge Care) Care Guide

Below the knee amputation (BKA) is surgery to remove all or part of your foot or your leg below the knee cap.

AFTER YOU LEAVE:

Medicines:

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

  • Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.

  • Take your medicine as directed. Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your primary healthcare provider or orthopedist as directed:

You may have a home health care nurse help you between your visits. You may need to return to have your stitches removed. Write down your questions so you remember to ask them during your visits.

Activity:

  • Slowly increase your activity level. Rest when needed, but try to exercise 2 to 3 times each day or as directed by your primary healthcare provider. Do not put weight on your residual limb until caregivers tell you it is okay. Many companies supply sports equipment for people with amputations. Talk to caregivers if you are interested in getting a prosthesis so you can stay active in sports.

  • Change your position often to remove fluids from your lungs and lower your risk of pneumonia. This also decreases the risk of pressure sores, and keeps your muscles and tendons from tightening.

  • Do not lift heavy objects.

  • Ask your primary healthcare provider when you can return to work or school. Ask when you can drive again.

Physical and occupational therapy:

Physical and occupational therapists will help you after your surgery. A physical therapist will help you with exercises to improve your strength. You may be fitted with a prosthesis, which may need to be adjusted several times before it fits well. Physical therapists will also help you learn to walk with the prosthesis and with crutches. Occupational therapists will help you adjust to daily activities at home and work.

Residual limb care:

  • Clean and care for your skin: When you are allowed to bathe, gently wash the incision with soap and water. Carefully rinse and dry your skin. Look closely at the skin on your residual limb every day. Use a hand mirror to see all sides of your residual limb. Watch for redness, blisters, or scrapes. Do not put lotion, oil, cream, or rubbing alcohol on your residual limb. Rubbing alcohol dries and cracks your skin.

  • Prevent infection: Wash your hands before you touch your wound. This will help prevent an infection. Only use antiseptic (germ-killing) medicines if caregivers tell you to.

  • Help your residual limb heal: Push the residual limb against a soft pillow. Slowly increase the pressure and start to push your residual limb against harder surfaces like the back of a chair. Massage the residual limb to soften the scar, decrease tenderness, and improve blood flow.

Wrap your residual limb:

Wrap the residual limb so it forms into a firm cone shape that will fit a prosthesis. At first you will not pull the elastic bandage very tight. Caregivers will have you pull the bandage tighter as your wound heals and the stitches are removed. If your residual limb hurts or throbs, the bandage may be too tight. Unwrap your limb and start over.

  • Figure of 8 method to wrap your residual limb:

    • Hold the bandage roll on your thigh with one hand. Use the other hand to roll the bandage diagonally down your thigh. Stretch the bandage slightly when you get to the bottom of your limb. Wrap the bandage around the end of the limb.

    • Roll the bandage around to the front. Continue diagonally up your thigh. The bandage will cross over itself. Roll the bandage all the way around the limb and to the front again.

    • Repeat these steps until your limb is completely covered from mid-thigh down. Overlap the bandage as you wrap, so that you are always covering new skin. If you need to use more than one bandage, secure each bandage with a clip or tape before you apply another one.

    • When you are finished, secure the last bandage. Try to end the bandage in a place that is not in a skin fold or at your knee joint.

  • Woolen residual limb socks: Wear a woolen residual limb sock when caregivers say you no longer need to wrap your residual limb. This keeps the limb clean and comfortable. Wash the woolen socks gently in cool water and soap to keep them from shrinking. Dry the socks flat on a towel to prevent stretching. Replace the sock if it gets torn.

For support and more information:

  • Amputee Coalition
    900 E. Hill Ave, Ste 290
    Knoxville, , TN 37915
    Phone: 1- 888 - 267-5669
    Web Address: www.amputee-coalition.org

Contact your primary healthcare provider or orthopedist if:

  • You have a fever.

  • Your stitches come apart.

  • Blood soaks through your bandage.

  • The skin around your stitches is red, swollen, or has pus coming from the incision.

  • You have a sudden increase in tenderness in your residual limb.

  • You have chills, a cough, or feel weak and achy.

  • Your skin is itchy, swollen, or has a rash. Your medicine may be causing these symptoms.

  • You have questions or concerns about your surgery or care.

Seek care immediately or call 911 if:

  • You have severe pain in your residual limb.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You suddenly feel lightheaded and have trouble breathing.

  • You have chest pain. You may have more pain when you take a deep breath or cough. You may cough up blood.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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