Post-Amputation Patient Care – Comprehensive Treatment

What is comprehensive post-amputation care?

Care for patients after an amputation is a multidisciplinary treatment that includes stump healing, pain management, surgical reconstruction, prosthesis selection, rehabilitation, and psychological support.

Its goal is not only to heal the wound, but above all to restore mobility and quality of life. Many patients struggle for years with pain, chafing, or a poorly fitting prosthetic socket, unaware that effective surgical solutions exist.

→ Read: Monika’s Story – How Osseointegration Restored Her Freedom After 36 Years of Living with an Amputation

When should you schedule a consultation?

A consultation is recommended if:

A funnel-shaped prosthesis causes pain, abrasions, chafing, or recurring sores,

your stump is too short, and it is difficult or impossible to fit the socket,

you experience phantom pain or severe stump pain that does not subside with medication,

You feel a sharp, "shocking" pain when pressure is applied. This may indicate a neuroma.

the prosthesis is unstable, slips off, or you have to constantly watch where you're going,

you can't sit comfortably in the prosthesis, or the rim of the socket presses against your groin,

The volume of the stump changes and the funnel no longer fits,

you have extensive scarring, skin grafts, or bony growths on the stump,

You are preparing for an amputation and want to plan it in a way that will make it easier to get a prosthesis later on.

Contact your doctor immediately if you experience any of the following:

increasing redness,

fever,

purulent discharge,

the wound to heal,

darkening of the skin on the stump.

How do you care for a stump after an amputation?

Daily stump care prevents complications and prepares the limb for prosthetics. It includes:

skin examination,

washing with a mild, unscented detergent,

thorough drying,

edema monitoring,

Exercises to prevent contractures.

For patients who have undergone osseointegration, the rules are different: maintaining good hygiene at the site where the implant passes through the skin is crucial.

→ Read the guide: How to Properly Care for a Stump After Amputation?

RPNI – Regenerative Peripheral Nerve Interface

What is RPNI?
RPNI (Regenerative Peripheral Nerve Interface) is a technique in which the end of a severed nerve is surrounded by a small muscle graft. The nerve innervates this section of muscle, which limits the chaotic growth of nerve fibers and the formation of a neuroma.

Indications: RPNI is used for the treatment and prevention of neuropathies, often in conjunction with TMR or as an alternative to it. The choice of method depends on the level of amputation and which nerves are affected.

Stump lengthening

What is stump lengthening? It is a procedure in which a stump that is too short is gradually lengthened using the method of distraction osteogenesis. This is the same principle underlying limb lengthening, a specialty of the Paley Institute. The bone is surgically cut and then slowly pulled apart using an external fixator or an internal implant. New bone tissue forms in the resulting gap.

Why lengthen the residual limb? A longer residual limb means a longer lever arm. This makes it easier to fit the prosthesis and improves control and stability. Lengthening may also enable osseointegration in patients who were previously ineligible for it.

Who is it for?
For patients:

with a very short stump of the thigh, lower leg, or arm,

with congenital limb hypoplasia,

following injuries in which a small fragment of bone has been preserved.

Family-Centered Care: treatment in which the family is part of the care team

Family-Centered Care (FCC, family-centered care) is the treatment model used at the Paley European Institute. The family of a child with a congenital limb defect is not merely an observer but a full-fledged member of the treatment team. Treatment for congenital limb defects often lasts for months or years and involves several surgeries, limb lengthening, and months of rehabilitation. Therefore, parents who understand the treatment plan and feel that their concerns are being heard have a real impact on its outcomes.

What does family-centered care look like in practice?

Parents do not wait in the hallway while their child is undergoing surgery—the Hospital Services Coordinator and the physician’s assistant keep parents updated on the progress of the procedure via WhatsApp. During this time, a psychologist stays by the parent’s side to support them through this most difficult hour.

One treatment plan instead of multiple visits —during the consultation, specialists from various fields meet with the child in one place and develop a comprehensive treatment plan. The conversation begins not with the question “What hurts?”, but with what the child likes to do and what the family’s daily life is like.

The same physical therapist before, during, and after surgery —the therapist present in the operating room—conducts rehabilitation starting on the first day of recovery. The child exercises with someone they already know, which reduces anxiety and facilitates a return to physical function. This is particularly important during limb lengthening, when systematic physical therapy is crucial for maintaining joint mobility.

Comprehensive care in one place —X-rays, blood tests, an orthotist, a psychologist, a dietitian, a speech therapist, and certificates for schools and government offices are available without unnecessary referrals or having to search for other facilities. Surgeries are performed at our partner hospital, Medicover, where the Paley European Institute team cares for the patient from admission through discharge.

Support for families from other cities and countries —families traveling here for medical treatment receive assistance with arranging transportation, accommodations, and all the logistics of their stay.

Parents' Council —parents who have themselves undergone treatment at the Paley European Institute—regularly test and evaluate new approaches, helping to shape the model of care.

Why does family involvement improve treatment outcomes?
Parents who understand the treatment plan are better able to follow rehabilitation recommendations at home and recognize signs that require contacting a doctor more quickly. Thanks to preparing the family for home care, children who undergo surgery at the Paley European Institute stay in the hospital for an average of only 2 days. A shorter hospital stay and less stress lead to a more peaceful recovery and a better quality of life for the entire family.