Can Bed Sores Lead to Amputation of Limbs? - Part 2

By Nursing Home Law Center

Yes. One of the most dramatic examples of how truly devastating bed sores can be is when a limb must be amputated due to severe bed sores. When bed sores are not treated properly, tissue damage can spread and infection, gangrene, can set in. In severe cases (where surgical debridement, antibiotics, and oxygen treatment are unsuccessful), amputation of the limb might be required to prevent the infection from spreading further. This is especially true in elderly people, especially those who are malnourished, because of poor blood flow.

Amputation is the surgical removal of a limb or body part (arms, legs, feet, fingers, toes), usually to remove diseased tissue or relieve pain. The amputation procedure is performed by an orthopedic surgeon in a hospital operating room under regional or general anesthesia.

The procedure varies depending on which limb is removed; however, all surgical amputations involve removing diseased tissue and constructing a stump, which will fit a prosthesis. The procedure for an above-the-knee amputation includes: first cutting the skin and muscle layers, then clamping the major blood vessels and cutting them, then cutting the bone with a bone saw, and finally, the muscles are stitched together over the bone and the skin is closed over the wound.

The decision of how much of the limb to remove depends on how much tissue needs to be removed for proper healing, while saving as much of the healthy skin, blood vessels, and nerve tissue as possible for rehabilitative purposes. One test that the surgeon performs to determine the health of the limb is the amount of blood flow to the affected region (measurement of blood pressure in the limb).

As with other major surgeries, amputation carries with it the same risks including complications with anesthesia, blood loss, and blood clots; however, infection is the main complication following surgery. Amputation is a painful procedure, requiring treatment with pain medication and antibiotics post-surgery, and a hospital stay ranging from five to fourteen days, absent further complications. Following surgery, the newly formed stump must be moved often to encourage circulation, with physical therapy commencing as soon as possible. The rehabilitative process is a long process, especially for above the knee amputees. The physical rehabilitation is often accompanied by grief counseling to help the patient cope with the sense of loss that comes with losing a limb. Patients also often have phantom limb pain, which is very difficult to treat. Amputation is a last resort for both physicians and patients, but in some cases, as with severe pressure sores (which are likely preventable), it becomes necessary.

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