OWAISI COLLEGE OF

NURSING
NURSING EDUCATION

LESSION PLAN
ON
AMPUTATION
 STUDENT PROFILE

Name of the student : B. Usharani

Name of the topic : Amputation

Subject : nursing education

Group :

Teaching and learning Activity : Lecture and discussion

Av aids : Charts, hand outs, flash cards, PPT, OHP

Time :

Date :04/12/2019

Place :

Supervised by :
OBJECTIVES:

GENERAL OBJECTIVE: By the end of my class the group will be able to gain in
depth knowledge regarding amputation.

SPECIFC OBJECTIVE: At the end of class , the group will be able to :

 Define amputation

 . Enumerate about incidence of amputation

 Explain about classification of amputation

 List out about etiology of amputation

 Enumerate about risk factors of amputation

 Explain about pathophysiology of amputation

 List out about clinical manifestations of amputation

 Describe about diagnostic evaluation of amputation

 Explain about management of amputation

 List out about complications of amputation

 Enumerate about prevention of amputation

TIME OBJECTIVE CONTENT TEACHING LEARNIN
ACTIVITY ACTIVITY

INTRODUCTION:

DEFINITION:
Amputation is the intentional surgical removal of a
limb or body part. It is performed to remove diseased
tissue or relive pain or due to trauma.
- N.K.Behera
Amputation is the removal of limb, part or total from
the body

INCIDENCE:
AGE-
 Common in 50-70 year
GENDER-
*male-75%
*female-25%
LIMBS-
*lower limb-85%
*upper limb-15%
INDICATION OF AMPUTATION:
 Trauma-RTA, gun shot
 Malignant tumors
 Nerve injuries & infection
 Extreme heat & cold-burn, gangrene
 Peripheral vascular insufficiency
 Congenital absence of limbs or malformation
 Severe infection
CAUSES OF AMPUTATION:
-Natural causes
-Accidental causes
-Ritual, punitive & legal amputations
-Cold steel & gunshot causes
NATURAL CAUSES:
=>Congenital absence
=> arterial disease
=>ergot and other toxins
=> wound infections
=>diabetes mellitus
=>dietary deficiencies
=> tumors
ACCIDENTAL CAUSES:
*falls when running or from heights
*crushing by trees
*savaging by crocodiles and sharks
*effects of earthquakes, violent storms

RITUAL, PUNITIVE & LEGAL

AMPUTATIONS:
Curing local pain
In removing deformity
Infection or gangrene
In saving

COLD STEEL & GUNSHOT CAUSES:

-Iron & steel weapons evolved fingers & hands
-destructive gunshot wounding, associated with
mortal sepsis
-boiling oil
TYPES OF AMPUTATION:
o Closed amputation
o Open amputation ( guillotine operation)
CLOSED AMPUTATION:
 It is done as an elective procedure
 After amputations, the soft tissues are closed
primarily over the bony stump
 Eg: above knee, below knee ect………
OPEN AMPUTATION ( GUILLOTINE
OPERATION):
 It is done as an emergency procedure
eg: life threatening infections
 After amputations, the wound is left open &
not closed
 2 types depending upon the skin flaps:
*open amputation with inverted skin flap
*circular open amputation

PRINCIPLES OF CLOSED AMPUTATION :

 Level of amputation
 Skin flaps
 Muscle
 Blood vessels
 Bone:
 Drains
 Compression dressing:
 Absolute bed rest with limb elevation
 Limb fitted
Level of amputation : it is very important to fit the
prosthesis.
Skin flaps: good skin coverage is important skin
should be mobile & sensitive
Muscle : is divided at least 5cm distal to the level of
intended bone section & sutured.
Methods of muscle suture :
Myodesis – muscle is suture to bone
Myoplasty- muscle is sutured to opposite
muscle group under appropriate tension
Blood vessels: doubly ligated & cut. Then the
tourniquet is released & hemostasis is completed
Bone: section above level of muscle section
Drains: removed after 48-72 hours
Compression dressing: either elastic or rigid plaster
dressing fitting immediately
Absolute bed rest with limb elevation: this is
acceptable for the conventional prosthesis with
adequate vascularity
Limb fitted: conventional prosthesis is fitted a
minimum of 8-12 weeks after surgery.
PRINCIPLE OF OPEND AMPUTATION:
Indication:
*severe infection
*severe crush injuries
TYPES:
  Open amputation with inverted skin
flaps : it is a common choice.
 Circular open amputation: wound is kept
open & closed by suture , skin graft or re-
amputation .
COMPLICATION OF AMPUTATION:
1. HAEMATOMAS
2. INFECTIONS
3. NECROSIS
4. CONTRACTURES
5. STUMP PAIN
6. STUMP EDEMA
7. BONE OVERGROWTH