The rehabilitation period following an arm or hand amputation is important for the healing of the residual limb, regaining mobility and preparing for possible prosthesis use. The following information provides a general overview with a focus on above-elbow (transhumeral) amputations. All procedures are planned individually in line with the specialist physician's assessment and the guidance of the rehabilitation team.
The General Process
Immediately after surgery, the priority is the person's general recovery and proper closure of the surgical wound. Once the wound has healed appropriately, the actual rehabilitation and prosthesis fitting process begins. In most cases, this process can take around six months. The total duration varies from person to person depending on general health, the level of amputation and how the residual limb responds to treatment. In later stages, the person's active participation in the process becomes increasingly important.
Edema Management
Edema, or swelling, is a normal reaction to amputation surgery and usually subsides over time. However, if it lasts a long time, it can both slow healing and make prosthesis fitting more difficult. For this reason, reducing edema is important in the early period:
- Early period: To avoid putting additional pressure on the wound and stitches, the residual limb is initially wrapped only loosely, and the dressing is changed regularly.
- Compression therapy: When the physician considers it appropriate, a tighter wrap that fits the residual limb closely is applied. This method helps reduce pain, aids scar healing, increases blood flow and reduces swelling; it also shapes the residual limb for a possible prosthesis.
Adjustable elastic bandages or silicone liners available in ready-made sizes may be used for compression. The application should never be so tight that it causes pain or reduces sensation in the limb. Compression therapy is continued until the size of the residual limb no longer changes; this is a sign that the swelling has subsided.
Exercises and Preparation
At the same time as edema management, exercises that lay the groundwork for learning to use an arm prosthesis can also be started. These generally include strengthening and stretching the muscles of the residual limb, shoulder, back and trunk.
- Positioning: Although keeping the residual limb constantly bent and raised may reduce pain at first, it can cause the muscles to shorten. For this reason, it is recommended to keep the limb extended as much as possible.
- Strengthening: Moving the limb several times a day supports range of motion, balance and circulation. Keeping the shoulder in particular mobile is important to prevent stiffness.
- Supporting muscles: Because body weight and balance change, strain may be felt in the back; regularly exercising the upper body, shoulder and leg muscles makes it easier to adapt to this change.
- Unaffected side: The remaining hand and arm can be trained to acquire new skills for daily activities.
Skin and Scar Care
Amputation wounds usually close within three to four weeks, and a scar begins to form. Full maturation of the scar, however, generally takes about eighteen months. During this period, skin and scar care comes to the fore:
- The scar and the surrounding skin need to be moisturized regularly; scars cannot produce the skin's natural moisture, and dry skin can make prosthesis use more difficult. Fragrance-free moisturizers are generally a suitable choice.
- Gently stimulating the skin, which can be oversensitive after amputation, with a soft brush or massage ball may help reduce sensitivity. These applications are always done from the end of the limb toward the body.
- It is important to clean the residual limb every day with lukewarm water and a fragrance-free, skin-friendly soap.
It is recommended to consult the prosthetist and the rehabilitation team about choosing suitable care products and moisturizers.
Support Team
The rehabilitation process is carried out through the joint work of a team of surgeons, physiotherapists, occupational therapists and prosthetists. An individual exercise, care and prosthesis fitting plan is created by this team in line with the physician's assessment.
This content is for informational purposes; for diagnosis and treatment, you should consult your physician.
