Long-term post-care for amputation

snarkypants

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I've been scouring the "amputation" topic, and I'm looking for information about long-term wound/scar/stump care. It sticks in my mind that a person who has a limb amputated needs to have compression on the stump for a time for circulation issues but my google searches, google books and other searches returned only immediate wound care, not long term.

The young, healthy character had an above-the-elbow surgical amputation in the US in the late-1800s, and it healed well enough. Does it need to be bound/bandaged daily? Even 5+ years later? How would they protect it (assuming that there would be pain at the amputation site if struck/bumped)?

Thanks for helping a n00b out!
 

Maryn

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My high school had two students whose legs had been amputated. (No, they did not end up together as so many wished. Ugh.) I don't know when Michelle lost her leg, but Bill's was about two years before I met him.He did not need to bandage or specially protect the stump except when he had trouble with the prosthesis fit because he'd grown or gotten heavier.

(Speaking of which, have you all read how 3D printers can make a functioning prosthetic hand for under $300? Amazing. Growing kids can get a new one as often as needed at that price.)

Maryn, hoping this long-ago observation helps
 

melindamusil

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Since you're talking late 1800s - remember that infection would be a major concern. Penicillin was not discovered until 1928. I know lots of men died in the American Civil War (1861-1865) from infections secondary to their injuries. Because of that I would imagine that they would change bandages frequently (though I have no source to back this up).

I don't know exactly when your character has his amputation, but also remember that germ theory (that is, the idea of diseases spread by microorganisms and the importance of cleanliness in medical care) didn't really take off until the 1880s or 1890s. In the American Civil War, doctors didn't wash hands or clean instruments between patients. When President James Garfield was assassinated in 1881, again, they did not wash hands or worry about clean instruments or dirt in the wounds, and he died from infection. But by the 1890s or 1900, you could pretty reliably count on the doctor keeping things clean.
 

snarkypants

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Absolutely, melindamusil! I love that info about Garfield's assassination. What a tragedy, but it brought about so many changes in the US!
 

CWatts

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Snarkypants, you may want to read up on John Wesley Powell, who lost his right arm at Shiloh. He led an expedition rafting the Colorado River and exploring the Grand Canyon only a few years later. It sounds like his amputation was very similar to your character's.

FYI, my WIP is set after the Civil War but before Garfield's assassination, so germ theory and antiseptics had been discovered but not widely accepted. I need to figure out how much my characters know. I'm tickled to think that an anarchist street-doc might know more about germs than the fancy doctors...
 

cmhbob

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I have an acquaintance who is an ERTL amputee (lower leg) after a fall from a ladder. He reports that his phantom pain comes and goes, with not much of a detectable pattern, although stress doesn't help.