Amputation

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Things you need to know

What is Amputation ?

Why do you need Amputation ?

Amputation is indicated for:

Trauma: Severe limb injuries (e.g., crush injuries, mangled extremities) where reconstruction isn’t feasible.
Peripheral vascular disease (PVD): Poor blood flow (e.g., in diabetes, atherosclerosis) causing non-healing ulcers, gangrene, or critical limb ischemia.
Infection: Uncontrolled infections (e.g., necrotizing fasciitis, osteomyelitis) not responding to antibiotics or debridement.
Malignancy: Bone or soft tissue tumors (e.g., osteosarcoma, sarcoma) requiring limb removal for cure or palliation.
Congenital deformities: Rare, when a malformed limb causes functional impairment (e.g., severe limb deficiency).
Chronic pain or non-functional limb: E.g., in severe neuropathy or failed limb salvage.

The procedure aims to remove diseased or damaged tissue, preserve as much function as possible, and prepare the stump for prosthetic fitting.

Why Do Costs Vary in Philippines?

Amputation Procedure

The procedure is tailored to the level of amputation and underlying condition:

Before Surgery Evaluation:
- Assessment:
  - Clinical exam: Assess limb viability (e.g., pulses, skin changes, infection), pain, and function.
  - Imaging (X-ray, MRI, Doppler ultrasound) evaluates bone, soft tissue, and vascular status.
  - Blood tests check for infection (e.g., WBC, CRP), diabetes control (HbA1c), and kidney function.
  - Angiography may assess blood flow in vascular disease cases.
- Multidisciplinary team (surgeon, prosthetist, physical therapist) plans the level of amputation and rehabilitation.
- Antibiotics (e.g., piperacillin-tazobactam) are started for infection; IV fluids and blood transfusions stabilize the patient.
- Psychological counseling prepares the patient for limb loss and lifestyle changes.
Surgical Techniques:
- Level of Amputation:
  - Determined by tissue viability, infection extent, and prosthetic fitting potential.
  - Upper Limb: Finger, hand, below-elbow, above-elbow, shoulder disarticulation.
  - Lower Limb: Toe, foot, below-knee (BKA), above-knee (AKA), hip disarticulation.
  - BKA and below-elbow are preferred when possible for better prosthetic outcomes.
- Procedure:
  - Performed under general or regional anesthesia (e.g., spinal), lasting 1–3 hours.
  - The skin is marked to create flaps for stump closure, ensuring adequate soft tissue coverage.
  - Muscles are divided and shaped (myodesis/myoplasty) to pad the bone and improve prosthetic control.
  - The bone is cut with a saw at the appropriate level, and the edges are smoothed.
  - Major vessels are ligated; nerves are carefully divided and buried in soft tissue to reduce neuroma formation.
  - The wound is irrigated, and the skin flaps are closed over a drain to prevent hematoma.
  - A stump dressing or rigid cast is applied to reduce swelling and shape the stump.
- Special Considerations:
  - In infection cases, the wound may be left open initially (delayed closure after 3–5 days).
  - In trauma, damage control (e.g., temporary shunting, fasciotomy) may precede amputation.
After Surgery:
- Patients are monitored in the ward or ICU (if unstable) for 3–7 days.
- Pain is managed with analgesics (e.g., morphine, paracetamol); nerve pain may require gabapentin.
- Antibiotics continue for 5–14 days if infection was present.
- Physical therapy starts within 1–2 days to prevent contractures and improve mobility.
- Prosthetic evaluation begins 4–6 weeks post-surgery, once the stump heals.

Recovery After Amputation

Hospital Stay: 3–7 days for uncomplicated cases; longer (7–14 days) for infection or trauma.
Post-Surgery Care:
- Pain managed with analgesics; phantom limb pain (50–80% of patients) may require gabapentin or amitriptyline.
- Stump care: Dressings changed daily; edema controlled with compression bandages or a shrinker sock.
- Antibiotics for 5–14 days if infection was present.
- Physical therapy: Early mobilization (e.g., bed-to-chair on day 1–2), strengthening exercises, and stump desensitization.
- Psychological support addresses grief, body image issues, and adaptation.
Activity/Diet:
- Crutches or wheelchair use for 4–6 weeks; prosthetic training starts at 6–8 weeks (once the stump heals).
- Strenuous activities avoided for 3–6 months; prosthetic use progresses gradually.
- High-protein diet (e.g., eggs, lentils) supports healing; 2–3 liters water daily.
Follow-Up:
- Visits at 1–2 weeks, 4–6 weeks to monitor stump healing and infection.
- Prosthetic fitting and adjustments every 3–6 months initially; lifelong prosthetic care required.

Recovery takes 3–6 months for basic mobility; full adaptation (with prosthesis) may take 6–12 months. Functional outcomes are better with BKA (80–90% ambulate with prosthesis) than AKA (50–70%).

Risks and Complications

Surgical Risks: Bleeding (2–5%), infection (5–10%), wound dehiscence (3–5%).
Stump Complications: Poor healing (esp. in PVD, 10–15%), neuroma (painful nerve ending, 5–10%), phantom limb pain.
General Risks: Anesthesia reactions, DVT (5–10%), pneumonia (esp. in elderly).
Long-Term: Prosthetic issues (e.g., skin breakdown, poor fit), psychological impact (e.g., depression, 20–30%), increased cardiovascular risk in PVD patients.

Report fever, severe pain, or stump redness promptly.

Frequently Asked Questions (FAQs)

What causes the need for amputation?

Trauma, vascular disease (e.g., diabetes, PVD), uncontrolled infection, or malignancy.

Can amputation be avoided?

Sometimes, with limb salvage (e.g., vascular bypass, debridement), but not if the limb is non-viable or life-threatening.

Will I feel pain after amputation?

Yes, surgical pain for 1–2 weeks; phantom limb pain (sensation in the missing limb) is common but manageable.

How soon can I walk with a prosthesis?

Prosthetic training starts at 6–8 weeks; walking independently may take 3–6 months.

Is amputation covered by insurance in India?

Yes, for trauma, infection, or malignancy; confirm with your provider.

Signs of complications?

Fever, severe pain, stump redness, or swelling.

Can I live a normal life after amputation?

Yes, with rehabilitation and prosthetics, most adapt well; psychological support helps with adjustment.

Lifestyle changes post-amputation?

Prosthetic care, physical therapy, manage comorbidities (e.g., diabetes), psychological support, regular follow-ups.

Conclusion

Looking for Best Hospitals for Amputation

Note: we are not promoting any hospitals

We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)

click on your city and schedule your surgery now done in good hands.

City	Minimum Price (₱)	Maximum Price (₱)
Angeles City
Antipolo
Bacolod
Bacoor
Baguio
Butuan
Cagayan de Oro
Caloocan
Cebu City
Dasmariñas
Davao City
General Santos
General Trias
Iligan
Iloilo City
Las Piñas
Makati
Malolos
Manila
Muntinlupa
Parañaque
Pasay
Pasig
Puerto Princesa
Quezon City
San Fernando
San Jose del Monte
Taguig
Valenzuela
Zamboanga City

Disclaimer

This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.

What is Amputation?

Amputation is a surgical procedure to remove a limb or part of a limb due to trauma, infection, vascular disease, or malignancy when preservation is not possible. It is often a last resort to save a patient’s life, control pain, or prevent disease spread. In the Philippines, amputation is performed in trauma centers, orthopedic surgery units, or vascular surgery departments at hospitals like St. Luke’s Medical Center, Makati Medical Center, The Medical City, and Philippine General Hospital (PGH), offering high-quality care at relatively affordable costs. For Filipino patients and families, understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for informed decision-making and optimal outcomes.

Why Do You Need Amputation?

Amputation is indicated for:

Trauma: Severe limb injuries (e.g., crush injuries, mangled extremities) where reconstruction isn’t feasible.
Peripheral Vascular Disease (PVD): Poor blood flow (e.g., in diabetes, atherosclerosis) causing non-healing ulcers, gangrene, or critical limb ischemia.
Infection: Uncontrolled infections (e.g., necrotizing fasciitis, osteomyelitis) not responding to antibiotics or debridement.
Malignancy: Bone or soft tissue tumors (e.g., osteosarcoma, sarcoma) requiring limb removal for cure or palliation.
Congenital Deformities: Rare, when a malformed limb causes functional impairment (e.g., severe limb deficiency).
Chronic Pain or Non-Functional Limb: E.g., in severe neuropathy or failed limb salvage.

The procedure aims to remove diseased or damaged tissue, preserve as much function as possible, and prepare the stump for prosthetic fitting. In the Philippines, hospitals like St. Luke’s Medical Center, Makati Medical Center, The Medical City, and PGH specialize in amputation, performed by orthopedic, vascular, or trauma surgeons.

Why Do Amputation Costs Vary in the Philippines?

Costs range from ₱100,000 to ₱1,000,000, based on:

Procedure Type:
- Minor amputation (e.g., toe, finger): ₱100,000–₱200,000.
- Major amputation (e.g., below-knee [BKA], above-knee [AKA]): ₱200,000–₱600,000.
- Complex cases (e.g., infection, trauma): ₱500,000–₱1,000,000.
Hospital/Location: Higher costs in Metro Manila hospitals (e.g., St. Luke’s, Makati Medical Center: ₱300,000–₱1,000,000); lower in public hospitals like PGH (₱50,000–₱200,000, often subsidized by PhilHealth or Z Benefit Package).
Surgeon’s Expertise: Experienced orthopedic or vascular surgeons charge higher fees.
Additional Costs: ICU stay (₱20,000–₱50,000/day), diagnostics (Doppler: ₱5,000–₱15,000; MRI: ₱10,000–₱30,000), antibiotics (₱10,000–₱30,000), prosthetics (₱100,000–₱400,000 for basic models), prolonged hospitalization.
Insurance: PhilHealth covers part (e.g., ₱20,000–₱100,000 depending on case type); private insurance may cover additional costs for trauma, infection, or malignancy. Confirm with your provider.

Amputation Procedure

The procedure is tailored to the level of amputation and underlying condition:

Before Surgery Evaluation:

Assessment:
- Clinical Exam: Assess limb viability (e.g., pulses, skin changes, infection), pain, and function.
- Imaging: X-ray, MRI, or Doppler ultrasound evaluates bone, soft tissue, and vascular status.
- Blood Tests: Check for infection (e.g., WBC, CRP), diabetes control (HbA1c), and kidney function.
- Angiography: May assess blood flow in vascular disease cases.
Preparation: Multidisciplinary team (surgeon, prosthetist, physical therapist) plans the level of amputation and rehabilitation. Antibiotics (e.g., piperacillin-tazobactam) are started for infection; IV fluids and blood transfusions stabilize the patient. Psychological counseling prepares the patient for limb loss and lifestyle changes.

Surgical Techniques:

Level of Amputation:
- Determined by tissue viability, infection extent, and prosthetic fitting potential.
- Upper Limb: Finger, hand, below-elbow, above-elbow, shoulder disarticulation.
- Lower Limb: Toe, foot, below-knee (BKA), above-knee (AKA), hip disarticulation.
- BKA and below-elbow are preferred when possible for better prosthetic outcomes.
Procedure:
- Performed under general or regional anesthesia (e.g., spinal), lasting 1–3 hours.
- The skin is marked to create flaps for stump closure, ensuring adequate soft tissue coverage.
- Muscles are divided and shaped (myodesis/myoplasty) to pad the bone and improve prosthetic control.
- The bone is cut with a saw at the appropriate level, and the edges are smoothed.
- Major vessels are ligated; nerves are carefully divided and buried in soft tissue to reduce neuroma formation.
- The wound is irrigated, and the skin flaps are closed over a drain to prevent hematoma.
- A stump dressing or rigid cast is applied to reduce swelling and shape the stump.
Special Considerations:
- In infection cases, the wound may be left open initially (delayed closure after 3–5 days).
- In trauma, damage control (e.g., temporary shunting, fasciotomy) may precede amputation.

After Surgery:

Patients are monitored in the ward or ICU (if unstable) for 3–7 days.
Pain is managed with analgesics (e.g., morphine, paracetamol); nerve pain may require gabapentin.
Antibiotics continue for 5–14 days if infection was present.
Physical therapy starts within 1–2 days to prevent contractures and improve mobility.
Prosthetic evaluation begins 4–6 weeks post-surgery, once the stump heals.

Recovery After Amputation

Hospital Stay: 3–7 days for uncomplicated cases; longer (7–14 days) for infection or trauma.
Post-Surgery Care:
- Pain Management: Analgesics for surgical pain; phantom limb pain (50–80% of patients) may require gabapentin or amitriptyline.
- Stump Care: Dressings changed daily; edema controlled with compression bandages or a shrinker sock.
- Antibiotics: For 5–14 days if infection was present.
- Physical Therapy: Early mobilization (e.g., bed-to-chair on day 1–2), strengthening exercises, and stump desensitization.
- Psychological Support: Addresses grief, body image issues, and adaptation, available in centers like The Medical City.
Activity/Diet:
- Crutches or wheelchair use for 4–6 weeks; prosthetic training starts at 6–8 weeks (once the stump heals).
- Strenuous activities avoided for 3–6 months; prosthetic use progresses gradually.
- High-protein diet (e.g., fish, eggs, legumes) supports healing; 2–3 liters water daily.
Follow-Up:
- Visits at 1–2 weeks, 4–6 weeks to monitor stump healing and infection.
- Prosthetic fitting and adjustments every 3–6 months initially; lifelong prosthetic care required.
Recovery takes 3–6 months for basic mobility; full adaptation (with prosthesis) may take 6–12 months. Functional outcomes are better with BKA (80–90% ambulate with prosthesis) than AKA (50–70%).

Risks and Complications

Surgical Risks:
- Bleeding (2–5%), infection (5–10%), wound dehiscence (3–5%).
Stump Complications:
- Poor healing (especially in PVD, 10–15%), neuroma (painful nerve ending, 5–10%), phantom limb pain.
General Risks:
- Anesthesia reactions, deep vein thrombosis (DVT, 5–10%), pneumonia (especially in elderly).
Long-Term:
- Prosthetic issues (e.g., skin breakdown, poor fit), psychological impact (e.g., depression, 20–30%), increased cardiovascular risk in PVD patients.
Report fever, severe pain, or stump redness promptly.

Frequently Asked Questions (FAQs)

What causes the need for amputation?
Trauma, vascular disease (e.g., diabetes, PVD), uncontrolled infection, or malignancy.

Can amputation be avoided?
Sometimes, with limb salvage (e.g., vascular bypass, debridement), but not if the limb is non-viable or life-threatening.

Will I feel pain after amputation?
Yes, surgical pain for 1–2 weeks; phantom limb pain (sensation in the missing limb) is common but manageable.

How soon can I walk with a prosthesis?
Prosthetic training starts at 6–8 weeks; walking independently may take 3–6 months.

Is amputation covered by insurance in the Philippines?
PhilHealth covers part (e.g., ₱20,000–₱100,000); private insurance may cover additional costs for trauma, infection, or malignancy. Confirm with your provider.

What are the signs of complications?
Fever, severe pain, stump redness, or swelling require immediate attention.

Can I live a normal life after amputation?
Yes, with rehabilitation and prosthetics, most adapt well; psychological support helps with adjustment.

What lifestyle changes are needed post-amputation?
Prosthetic care, physical therapy, manage comorbidities (e.g., diabetes), psychological support, regular follow-ups.

Conclusion

Amputation, while a significant intervention, can be life-saving and improve quality of life when limb preservation isn’t possible. The Philippines’ top hospitals (St. Luke’s, Makati Medical Center, PGH) offer expert care at costs ranging from ₱100,000 to ₱1,000,000, often partially covered by PhilHealth or private insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach amputation confidently. Consult an orthopedic or vascular surgeon for personalized guidance and successful rehabilitation.

Looking for Best Hospitals for Amputation

Note: we are not promoting any hospitals

click on your city and schedule your surgery now done in good hands.

City	Minimum Price (₱)	Maximum Price (₱)
Angeles City	50,000	150,000
Antipolo	50,000	150,000
Bacolod	50,000	150,000
Bacoor	50,000	100,000
Baguio	50,000	150,000
Butuan	50,000	100,000
Cagayan de Oro	50,000	150,000
Caloocan	50,000	100,000
Cebu City	70,000	200,000
Dasmariñas	50,000	100,000
Davao City	70,000	200,000
General Santos	50,000	150,000
General Trias	50,000	100,000
Iligan	50,000	150,000
Iloilo City	50,000	150,000
Las Piñas	50,000	150,000
Makati	70,000	200,000
Malolos	50,000	100,000
Manila	70,000	200,000
Muntinlupa	50,000	150,000
Parañaque	50,000	150,000
Pasay	50,000	150,000
Pasig	70,000	200,000
Puerto Princesa	50,000	150,000
Quezon City	70,000	200,000
San Fernando	50,000	100,000
San Jose del Monte	50,000	100,000
Taguig	70,000	200,000
Valenzuela	50,000	100,000
Zamboanga City	50,000	150,000