Taking Care of Your Residual Limb
Post-surgery, you will be taught how to properly care for your residual limb. This is the part of your limb that remains after amputation. Proper residual limb care and prosthetic device maintenance are essential to your health and mobility. Without it, you risk the limb’s skin becoming rough, scaly, and infected. Follow our tips below and learn to incorporate them into your daily routine.
Before the Sutures or Staples Come Out
During surgery, the wound will have been closed with sutures or staples. Your residual limb may be covered by a cast or splint. Or, another type of pressure dressing may be used, such as soft gauze covered by a tight bandage. This dressing is used to absorb moisture, protect your healing wound, and control swelling. No matter which type of dressing is used, it is likely to be changed often. This lets your health care team check how your wound is healing. You (or a family member) may also be taught how to change the dressing. It will need to be kept dry while in the shower or bath. Tell your doctor if the cast or splint or dressing feels loose.
Working with a Physical Therapist
While in the hospital, you’ll work with a physical therapist (an expert in exercise and rehabilitation). He or she will teach you how to move your limb safely. You’ll learn how to transfer (move) between two surfaces, such as a bed and a chair. You’ll also learn how to support your residual limb when you sit and lie down. This helps prevent the shortening of muscles and tightening of joints. You will be given an exercise program to continue at home.
After the Sutures of Staples Come Out
Your sutures or staples will be removed about 3 weeks after surgery. Once the sutures or staples are removed, desensitization can begin. This involves gently massaging, tapping, and rubbing your residual limb. Do this a few times each day. Desensitization helps prepare your limb for a prosthesis. It can also help relieve phantom pain and decrease phantom sensation. Wash your residual limb with plain soap and water, and gently pat dry. Do this at least once a day. And don’t pick at scabs that form over your scar. While in the hospital, you’ll learn about scar massage. Scar massage can begin when the sutures or staples are out and the wound has completely healed.
Desensitization of the Residual Limb
After amputation, the skin on your residual limb will be sensitive to the touch, and eventually, when the prosthesis is fitted, and you are starting to walk, it will be subjected to forces it was never intended to cope with. To develop a tolerance for these forces you will need to desensitize your residual limb. Desensitization techniques may also decrease what is known as phantom pain (the sensation of pain in the absent part of a limb.
- Start with light and gentle touching and tapping, and then progress to a light massage. As your tolerance improves, slowly increase the pressure.
- Rub the skin with different materials: start with a cotton wool ball, rubbing it in a circular motion. As you develop more tolerance, progress to rougher materials such as paper towels and various kinds of brushes.
- Try to do this for 15 to 20 minutes, three times a day, until desensitization is fully achieved.
NOTE: Be especially cautious when massaging or rubbing the sutured area so as not to damage the skin.
Daily Limb Care and Hygiene
Keeping your residual limb clean is vital to prevent skin problems and infection. Do the following every day:
- Wash your residual limb at least once a day. Use warm water and mild antibacterial soap.
- Using a washcloth, scrub gently over all surfaces of the residual limb. Pay close attention to the skin behind your knee and on the bottom of your limb.
- Dry your residual limb thoroughly. This keeps moisture from being trapped between your skin and the shrinker sock.
- Wear a clean shrinker sock every day. Wash each sock with mild soap and water, rinse well, and air dry completely. This removes salts and acids left by your sweat.
When to Call the Surgeon
While the wound is healing, watch closely for signs of infection or other problems. Call the surgeon right away if you notice:
- Wound or residual limb has a bad smell.
- Cast, splint, or dressing loosens or falls off.
- The area around the wound is warm or hot or becomes red or swollen.
- Pus or yellow drainage from the wound, or thick discharge that is brownish gray.
- Wound reopens for any reason.
- A sudden increase in pain or severe tenderness.
- Fever of 100.4F (38.0C) or higher.
We are here to help. Contact us at Texas Orthotic and Prosthetic Services to get answers for your questions.
