Amputation is the general term describing a condition of disability resulting from the deliberate surgical removal of a part of the body, a limb, or part of a limb (Bowker & Michael, 1992). Limb loss can be a congenital condition, the result of traumatic injury, or a surgical procedure to treat disease (Clawson, 2009). Clawson posits that the majority of amputations in the United States are the result of vascular disease caused by diabetes (p. 393). In cases of traumatic amputation, adjustment and adaptation is more difficult than for people who have had time to prepare, such as may occur with diabetes. Amputations may be performed at any level in the upper extremities such as the digits, the hand, or the arm, or in the lower extremities
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It is usually performed under a general or regional block anesthetic, although a local anesthetic is sometimes used for finger or toe amputations (Bowker and Michael, 1992). Because of ever improving surgical techniques, postoperative rehabilitation, and prosthetic design most individuals who undergo amputation return to high levels of functioning after reconstruction and rehabilitation. Marshall and Stansby (2008) posit that partial or full loss of an extremity invariably produces some degree of permanent disability, although persons who go through lower extremity amputation are likely to regain mobility. Prostheses typically provide limited return of normal function in the case of upper extremity amputation. However, amputations of fingers and thumbs most often decrease the ability to accomplish tasks requiring manual dexterity.
Complications of amputation include edema (swelling of tissues), contracture (abnormal, often permanent shortening of muscle tissue), infection, and pain (Seymour as cited in Clawson, 2009, p. 394). A certain amount of edema at the stump (the distal end of a post-amputation limb) generally occurs following surgery, although early fitting of prosthesis will curtail this type of edema. Prompt medical attention is needed if excessive edema occurs; otherwise, ulceration of the skin can develop. Skin ulcerations also occur because of infection or an ill-fitting prosthesis. Hot, humid climate and unsanitary conditions can also lead to