Below The Knee Amputation

What you should know

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

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • During or after surgery, you may bleed more than expected. Blood may collect under your skin and form a lump called a hematoma. This may need to be drained to prevent infection. It may be difficult for your wound to heal and you may get a wound infection. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.

  • Some people continue to feel the part of their leg that has been amputated. These are called phantom feelings. These feelings are normal and may or may not be painful. If you do not have surgery, your problem could get worse. If you have cancer or a badly infected leg and do not get treatment, with time you could die. Call your caregiver if you are worried or have questions about your medicine or care.

Getting Ready

Before your surgery:

  • If you know in advance that you are going to have BKA surgery, caregivers may test your other leg. These tests help you prepare for moving after surgery. You may also be given exercises to do to make your arms stronger. This will help you use crutches or a wheelchair after surgery.

  • You may need blood tests before your procedure. Write down the date, time, and location for each test.

  • If caregivers think you may need a blood transfusion during surgery, you may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than several days before surgery. You may also ask a family member or friend with the same blood type to donate their blood. This is called directed blood donation. Talk to your caregiver for more information on autologous or directed blood donation.

  • You may be given a pill to take to help you sleep the night before surgery.

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • Write down the correct date, time, and location of your surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Ask your caregiver before taking any medicine on the day of surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.

  • Do not wear contact lenses the day of surgery. You may wear your glasses.

  • If you are staying in the hospital after surgery, bring your personal belongings with you. These include your bathrobe, toothbrush, hairbrush, and slippers. Do not wear jewelry or bring money to the hospital.

  • An anesthesiologist may talk to you before your surgery. This is the caregiver who gives you medicine before and during surgery so that you do not feel or remember the surgery.

Treatment

What will happen:

  • You will be asked to change into a hospital gown. You may be given medicine in your IV to help you relax or make you drowsy. You will be taken on a cart to the operating room. You will get general anesthesia to keep you completely asleep during surgery.

  • During surgery, caregivers will try to remove the diseased tissue so that your wound will heal well. Caregivers will only remove as much of the foot or leg as is absolutely necessary. An incision (cut) will be made in your leg as far below your knee or in your foot as possible. The part of your leg below that will be removed, and your lower leg bones will be made smooth. A flap, made of muscle, tissue, and skin will be made to cover the end of your bones. If your leg was infected before surgery, caregivers may not put stitches or staples in to close it right away. The incision may be left open for several days after surgery. If no infection was present, the incision will be closed with stitches. The surgery may last 1 to 2 hours.

After Surgery:

You will be taken to a recovery room. You will stay there until you wake up, and then be taken back to your room. A bandage will cover your stitches. Do not try to get out of bed until your caregiver says it is okay.

Contact a caregiver if

  • You cannot make it to your surgery appointment on time.

  • You have questions or concerns about your surgery.

  • You have a fever.

Seek Care Immediately if

  • You have chest pain or trouble breathing.

© 2014 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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