Amputations

An amputation is a difficult decision, which the medical team only takes after considering every other option. It involves removing a toe, part of the foot or part of a limb when it is destroyed, severely infected or deprived of blood supply, and puts the patient's health or life at risk. The most common causes are diabetic foot complications (wounds that will not heal, bone infection), poor blood supply to the legs due to narrowed arteries, and more rarely severe injuries or certain tumours. Before deciding, the team checks whether the circulation can be improved, for example with a procedure on the arteries, and aims to preserve as much length as possible. The operation removes tissue that cannot heal and shapes a stump well covered with skin and muscle, which can later bear a prosthesis. For a toe, the procedure is limited and walking usually remains possible with suitable footwear. For a higher amputation, rehabilitation and a prosthesis allow many patients to walk again. At Clinique Pasteur Tunis, the decision is explained to the patient and family, without haste whenever the situation allows. Care brings together surgeons, anaesthetists, physicians to manage diabetes, nurses for wound care and physiotherapists, with particular attention to pain and to how the patient is coping.