Amputations: Caring for the Remaining Limb

Amputations of a lower limb mean extra stress (and higher risk) for the remaining limb that now must support the entire weight of the body.  This is especially true in amputations related to diabetes, where the conditions that led to the amputation in the first place (neuropathy or decreased nervous sensation and poor circulatory health) continue to plague the remaining limb.  Moreover, foot ulcers (open wounds on the foot that are the usually the starting place for an infection that ultimately requires amputation) tend to reform in the same areas.  So if the amputee has had a history of foot ulcers on his or her remaining limb, then vigilance is absolutely essential to ensure that a second amputation will not be necessary.  

The remaining limb of a lower limb amputee – whether the amputee is a diabetic or not – should be regarded as high-risk for ulceration and future amputation.  Routine care must become part of the amputee’s daily life.  The remaining limb (as well as residual limb) should be kept clean and inspected regularly.  If the amputee is unable to perform this inspection whether due to impaired vision or reduced mobility, then a family member of friend should be called in to assist.  The inspections should occur on a regular schedule and a physician should be consulted whenever something questionable arises.  

Due to the added stress on the remaining limb, minor foot injuries and foot deformities are more likely to occur.  Be on the look out for calluses, corns, blisters, claw toes, hammertoes or bunions that make the foot vulnerable to ulceration and could ultimately lead to future amputation.  Be careful when attempting to deal with calluses, corns or blisters.  A popped blister is ripe for infection.  Likewise when attempting to remove dead or damaged skin from a callus or corn (debridement) extra caution must be used to ensure that further damage is not done to the skin.  Avoid tearing the tissue surrounding a callus and stop immediately if bleeding occurs.  

Although it may seem like a good idea to use various adhesive padding or tape (i.e., Dr. Scholls, moleskin, etc.) to help protect the feet from calluses, corns, blisters, bunions, etc., it is actually a better idea to invest in shoes or orthopedic insoles that will support your remaining limb.  Shoes that fit properly will not cause calluses or blisters!  And for an amputee, preventative care when it comes to the remaining limb is the answer.  Foot injuries and foot ulcers are far easier to prevent than they are to treat.