rehabilitation of lower limb amputee jade
TRANSCRIPT
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
1/47
mputation
By
: MARIA JADE M. PINALBA
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
2/47
Amputation: the surgical removal of a part of thebody, a limb or part of a limb
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
3/47
Statistics Canadians with diabetes are 23 times more likely to be hospitalized for a
limb amputation than someone without diabetes
More than 4,000 Canadians with diabetes had a limb amputated in 2006.
30% of Canadians with diabetes will die within one year of amputation.69% of limb amputees with diabetes will not survive past five years
Lower limb amputations are 4 times more common than upper limb(infection) .
While over 90% of amputations caused by vascular disease involve the
lower limb, nearly 70% of amputations caused by trauma involve theupper limb
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
4/47
Statistics
For both males and females, risk of traumatic amputations
increased steadily with age, reaching its highest level amongpeople age 85 or older
Limb amputations resulting from cancer most commonly
involved the lower limb; above-knee and below-kneeamputations alone accounted for more than a third (36 percent)of all cancer-related amputations.
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
5/47
Causative Factors ofAmputations
Peripheral arterial disease
Diabetes Mellitus
Gangrene (due to thecomplication of & plaster cast ) .
Trauma (crushing, frost bite,
burns)Congenital deformities
Chronic Osteomyelitis
Malignant Tumor
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
6/47
Complications of diabetes that contribute
to the increased risk of foot infection
include:
1. Neuropathy
a. Sensory
b. Autonomic
c. Motor2. Peripheral vascular disease .
3. Immuno-compromise
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
7/47
High Risk Characteristics for
Developing Foot Infections
Duration of diabetes more than 10 years
Age > 40 years
History of smoking
Decreased peripheral pulses
Decreased sensation
History of previous foot ulcers or amputation
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
8/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
9/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
10/47
Should be preserved
Should be resected
So&So
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
11/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
12/47
Pre-operative Assessment
Neurovascular and functional status of extremity
Function and Condition of residual limb (in case of
traumatic amputation)
Circulatory status and function of unaffected limb
Signs & Symptoms of infection (culture required)
Nutritional Status
Concurrent medical problems
Current medications
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
13/47
Emotional reaction to
amputation
Circumstances surrounding
amputation (ie. Traumatic versus
surgical)
Occupational and social
Rehabilitation
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
14/47
Primary Amputation
Above the Knee PrimaryAmputation
Site of
Amputation
http://www.youtube.com/watch?v=IakCVCBtoUYhttp://www.youtube.com/watch?v=IakCVCBtoUYhttp://www.youtube.com/watch?v=IakCVCBtoUYhttp://www.youtube.com/watch?v=IakCVCBtoUY -
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
15/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
16/47
Monitor for complications
Pain management
Education & support
Promote mobility/ independent self-careEnhancing Body Image
Promote wound healing
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
17/47
Wash at night
Mild, fragrance free soap or antiseptic cleaner
Rinse well
Dry thoroughly
General wound care
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
18/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
19/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
20/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
21/47
Hemorrhage
Infection
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
22/47
Complication of
Amputations
Joint contracturesEnergy issues
Phantom limb pain
Bony growth
Skin Breakdown
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
23/47
What is PLP?
The somatosensory homonculus
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
24/47
Levels of lower limb amputation
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
25/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
26/47
Lower Limb Prosthesis
Types of lower limbsprostheses :
Types of L.L. prosthesesdepend on different stages
after amputation. There arethree types:
- Immediate post-operative prosthesis.
- Temporary prosthesis
- Definitive prosthesis.
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
27/47
Types of Prosthesis
BELOW KNEE
KNEE
DISARTICULATION ABOVE KNEE
HIP
DISARTICULATION
PROSTHETICS
LOWER EXTREMITY
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
28/47
Prosthetics
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
29/47
There are 5 Stages of Rehabilitation:
1. Healing and Starting Physiotherapy
2. Visiting the Prosthetist
3. Choosing an Artificial Limb
4. Learning to Use your Artificial Limb
5. Life as a New Amputee
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
30/47
Rehabilitation of lower limb amputee :
Therapy plays an integral role in preparing a patient for a
lower-extremity orthotic or prosthetic device and training
them with that device once it has been fabricated.
Once a patient receives a prosthetic or orthotic device, thetherapist is then responsible for evaluating that patient with
their device
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
31/47
Exercise After Amputation
ROM to prevent flexion
contractures, particularly of thehip and knee
Trapeze and overhead frame Firm mattress
Prone position every 3 to 4
hours Elevation of lower-leg residual
limb controversial
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
32/47
Nursing Diagnosis
Impaired Physical Mobility
Risk for infection
Risk for injury
Risk for Ineffective Tissue
Perfusion
Disturbed Body Image Self Care Deficit
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
33/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
34/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
35/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
36/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
37/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
38/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
39/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
40/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
41/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
42/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
43/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
44/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
45/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
46/47
-
8/12/2019 Rehabilitation of Lower Limb Amputee Jade
47/47