Prosthetic Care
Amputation: What to Expect at Home
Your Recovery
Your doctor removed the leg while keeping as much healthy bone, skin, blood vessel, and nerve tissue as possible.
After the surgery, you will probably have bandages, a rigid dressing, or a cast over the remaining part of your leg (remaining limb). The leg may be swollen for at least 4 weeks after your surgery. If you have a rigid dressing or cast, your doctor will set up regular visits to change the dressing or cast and check the healing. If you have elastic bandages, your doctor will tell you how to change them.
You may have pain in your remaining limb. You also may think you have feeling or pain where your leg was. This is called phantom pain. It is common and may come and go for a year or longer. Your doctor can give you medicine.
You may have already started a rehabilitation program (rehab). You will continue this under the guidance of your doctor or physiotherapist. You will need to do a lot of work to recondition your muscles and relearn activities, balance, and coordination. The rehab can last as long as a year.
If you are getting an artificial leg, you may need to get used to it before you go back to work and your other activities. You will probably not wear it all the time, so you will need to learn how to use a wheelchair, crutches, or other device. You will have to make changes in your home. Your workplace may be able to make allowances for you.
Having your leg amputated can be traumatic. And learning to live with new limits can be hard and frustrating. Many people feel depressed and may grieve for their former lifestyle. It's important to understand these feelings. Talking with your family, friends, and health professionals about your frustrations is an important part of your recovery. You may also find that it helps to talk with a person who has had an amputation.
Remember that even though you've lost a limb, it doesn't change who you are or prevent you from enjoying life. You'll have to adapt and learn new ways to do things. But you can still work and take part in sports and activities. And you can still learn, love, play, and live life to its fullest.
Many organizations can help you adjust to your new life. For example, you can go to www.amputeecoalition.org for information and support.
This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.
How Can You Care for Yourself at Home?
Activity
- Be active. Talk to your doctor about what you can do. If you are active and use your remaining limb, it will heal faster.
- You may shower when your doctor okays it. Wash the remaining limb with soap and water, and pat it dry. You may need help doing this at first.
- You may need to adapt your car to your situation before you drive.
- You will probably be able to return to work and your usual routine when your remaining limb heals. This can be as soon as 8 to 10 weeks after surgery, but it may take longer.
Diet
- You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
- You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. Take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.
Medicines
- Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
- If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
- Be safe with medicines. Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
- If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
Remaining limb care
- You may have bandages, a rigid dressing, or a cast on your remaining limb. Your doctor will tell you how to take care of it. Depending on your dressing and the doctor's instructions:
- Check your remaining limb daily for irritation, skin breaks, and redness. Tell your doctor about any problems you see.
- Wash your remaining limb with mild soap and warm water. Pat it dry.
Exercise
- Rehabilitation is a series of exercises you do after your surgery. This helps you learn to use your remaining limb and artificial leg. You will work with your doctor and physical therapist to plan this exercise program. To get the best results, you need to do the exercises correctly and as often and as long as your doctor tells you. Your rehab program will give you a number of exercises to do. Always do them as your therapist tells you.
Other instructions
- Preventing contractures is very important. A contracture occurs when a joint becomes stuck in one position. If this happens, it may be hard or impossible to straighten your remaining limb and use an artificial leg.
- Make sure you put equal weight on both hips when you sit. Use firm chairs, and sit up straight.
- Keep your remaining limb flat with your knees straight and your legs together while you are lying on your back.
- Lie on your stomach as much as possible to stretch your hip joint.
- Do not sit for more than an hour or two. Stand, or lie on your stomach now and then.
- Do not put pillows under your hips or knees or between your thighs.
- Do not rest your remaining limb on crutch handles or a wheelchair.
- Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems.
When Should You Call for Help?
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You have chest pain, are short of breath, or you cough up blood.
Call your doctor or seek immediate medical care if:
- You have pain that does not get better after you take pain medicine.
- You are sick to your stomach or cannot drink fluids.
- You have loose stitches, or your incision comes open.
- You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness or swelling in your leg.
- You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
- You bleed through your bandage.
Watch closely for any changes in your health, and be sure to contact your doctor or nurse if you have any problems.
The following information will help you to use and take care of your prosthesis.
Donning (putting the prosthesis on) and Doffing (taking the prosthesis off):
- Before donning, inspect your limb to make sure there are no areas of redness or abrasion.
- Each time you remove the prosthesis, examine your residual limb for areas of excessive redness, irritation, or swelling. Check your skin with your eyes and with your hands (especially if you have altered sensation from neuropathy, poor circulation, or diabetes). If redness does not go away within 20 to 25 minutes, discontinue use and contact your prosthetist.
- If your prosthesis causes pain or discomfort, check the following:
- Check to be sure the prosthesis is properly positioned on your residual limb. Is it rotated? Use your kneecap (if you have a below-knee amputation) or your sit bone (if you have an above-knee amputation) as landmarks to tell whether the socket is properly positioned.
- Check to be sure you are wearing the correct number of socks. Did you try adding or removing a sock? Sock ply may change dramatically during the first few weeks of wear, especially if this is your first prosthesis. Many people find it necessary to add or remove a sock during the day
- Consider your wearing schedule. Did you wear it too long?
Here are a few helpful hints for donning (putting on) various types of prostheses:
Gel liner: Turn liner inside out and make sure bottom is flat, with no air space at the bottom, before you roll it onto your limb. A below-knee liner is cut straight at the top. An above-knee liner is slanted at the top, with the shorter side on the inside of your thigh and the longer side on the outside of your hip. If your liner has a pin at the bottom, make sure the pin points straight out from the bottom of your residual limb and is not tilted forward or to the side. If you have trouble getting the pin to lock, try taking the liner off and put it on again, taking care to line the pin up straight. If you wear a seal-in liner, be sure that the seal lays flat before putting the prosthesis on. If you wear socks with your seal-in liner, be sure the socks are tucked under the seal and do not cover the seal.
Socks: At the beginning of each day and throughout the day, be sure to check whether you are wearing the right number of socks. If you are not wearing enough socks, you may feel too much pressure at the very bottom of your limb and you may feel that you are sinking in too far. If you are wearing too many socks, you may feel that your limb is too high in the socket and there is space between the end of your limb and the bottom of the socket. You may also see a purplish color at the bottom of your limb after you take the prosthesis off. Try removing a sock or notify your prosthetist if you are already wearing as few socks as possible. Be sure that your limb always touches the bottom of the socket – there should not be any air space below your limb.
Valve: If your prosthesis has a valve that screws in and out of the socket, be sure to check the valve hole each time you put the prosthesis on. Put one finger through the valve and be sure that your limb completely touches the valve opening. You should not be able to fit your finger into the socket or under your residual limb when your limb is donned properly.
Sleeve: If your prosthesis has a knee sleeve that goes up onto your thigh, be sure the gel material touches your skin or binds with the gel liner that you roll down. You may have to shorten your socks or fold the top of your sock down if the sleeve does not contact your skin.
Belt: If you wear a belt to hold your prosthesis on, be sure the belt is tightened securely around your hips and be sure that the prosthesis is rotated properly before securing the belt.
Wearing Your Prosthesis:
- Wean into the prosthesis for the first few days, slowly increasing the number of hours worn each day. It is important to allow your residual limb time to accommodate to your new prosthesis. Avoid very strenuous activity during the first week to ensure a comfortable transition to your new prosthesis.
- A sample wearing schedule is as follows. If you notice redness, irritation, blisters, or wounds, discontinue wear and contact your prosthetist.
- Week 1: 5-10 min per hour of standing or walking with walker.
- Week 2: 10-15 min per hour of standing or walking with walker/cane.
- Remove prosthesis and inspect your limb at each break.
- Do not attempt to use the prosthesis independently until directed by your physical therapist.
- Follow the safety precautions that your prosthetist and therapist have given you. You may need to use a walker or cane when you are learning to walk with the prosthesis. Be aware of changes in surface when you are walking. The transition from smooth tile floors to rough carpet can cause you to stumble if you are unaware of the change.
- Any changes in activity level will affect the function of the prosthesis. If your activity level changes (for example, you are progressing through your initial gait training with your therapist), contact your prosthetist for a recheck of the alignment and function of the prosthesis.
- The prosthesis is for use in normal conditions and environments. Avoid water, high impact activities, or contact with corrosive chemicals.
- Always wear a shoe with your prosthesis. Walking without a shoe may cause you to feel like you are falling backward. You can change shoes, but be sure that they have the same heel height as the shoes you wore to your appointments with your prosthetist. If you are unsure if shoes have the same heel height, call and make an appointment with your prosthetist to have them evaluated.
Caring for Your Residual Limb:
- Wash your residual limb daily with a mild soap and water, rinse and dry carefully. Do not soak as this makes the skin tender. The best time to cleanse your residual limb is at night. Your residual limb must be thoroughly dry before putting on your prosthesis. If you perspire excessively during the day, remove your prosthesis and pat your limb dry, changing socks if needed. Discontinue wearing your prosthesis while waiting for a breakdown or abrasion to heal. Report any concerns to your prosthetist or treating physician.
- Do not shave your residual limb or apply lotions or moisturizers to your residual limb, unless instructed by your prosthetist.
- Any changes in body weight may alter the fit of the prosthesis. If your weight changes, make an appointment with your prosthetist or physician to have the fit evaluated.
Caring for Your Prosthesis:
- Socket: For optimum function clean the interior of the socket every day. Use a sponge or soft cloth and a little mild soap. Remove soap residue with a sponge or cloth flushed with clear water. Your prosthesis should not be submerged in water. Let dry overnight. Clean the exterior the same way when needed. If your prosthesis develops an odor, speak with your prosthetist to be sure you are cleaning your device and your limb as best as possible.
- Gel Liner: Wash your liner every evening according to the manufacturer’s instructions and put on a clean liner each morning. You should have two liners so that one may be washed while the other is worn. Gel liners, socks, and sleeves should normally be replenished every 6-12 months for proper hygiene and function.
- Socks: Put on clean socks every day and wash soiled socks according to the manufacturer’s instructions. The sock must fit snugly, without wrinkles, to avoid pressure points on your residual limb.
- Suspension Sleeve: Be careful when donning the sleeve to not puncture it with a finger or finger nail. The sleeve can be rolled down and hand washed weekly with mild soap. Rinse the sleeve well; soap residue may cause irritation to the skin. Allow the sleeve to air dry. The sleeve may slide down on the socket over time. Be sure that a few inches of gel material are always contacting your skin when you put on your prosthesis.
- Mechanical Parts / Components: Schedule a recheck appointment with your prosthetist at least once per year to ensure optimal function. Do not adjust screws, joints or other parts yourself. If you hear any unusual noise such as clicking, grinding or cracking, discontinue use and contact your prosthetist. Report any black or metallic dust to your prosthetist.
Please don’t hesitate to contact us if you have any questions or concerns about your prosthesis. We are happy to be working with you!