Trauma accounts for 20–25% of lower limb amputations, while it is the most common cause of upper extremity amputations. Amputations can occur at different levels, details of which are beyond the scope of these guidelines. Please find below some general considerations.

Clinical management issues to consider

Involve rehabilitation team prior to surgery to discuss stump length and type if required

• date, level and cause of amputation
• details and recommendations of surgical team involved
• potential complications – tissue viability, infection etc
• removal of drains, date for removal of clips / stitches
• documentation of neurovascular status of limbs
• plan for review of stump wound plus change of dressings – soft vs rigid, vac dressings
• documentation of fractures plus review of X-rays with potential impact on mobility
• current management of stump and phantom pain

Throughout admission

• monitor stump wound healing
• control stump volume, eg. Juzo® shrinking sock
• clarify with the trauma team regarding weight bearing status, the management and monitoring of other associated injuries if applicable
• monitor nutrition (use weight chart and MUST scoring chart)
• identify if there is a need for psychological support
• physiotherapy involvement – maintenance of range of movement (ROM) of joints of amputated limb (prevent contractures) plus strengthening exercises, aerobic conditioning, mobilisation (eg. P-PAM aid/Femurette) and balance training with consideration of other injuries / issues
• OT involvement regarding personal care and assessment for provision of wheel chair if applicable

Discharge planning

• OT access visit if applicable plus follow up plan including vocational aspect
• make referral to patients local area wheelchair services if applicable
• physiotherapy follow up plan
• wound follow up if necessary
• amputee primary clinic appointment