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Amputation vs limb salvage: Is lower limb salvage a viable alternative?

We take a look at lower limb salvage and the alternatives to an elective amputation and assess how amputation affects compensation.

For patients with serious traumatic upper or lower limb injuries that fall short of amputation, limb salvage vs amputation is a difficult discussion that arises for healthcare professionals and their patients.

The decision to amputate or salvage a limb is usually based on several factors, including the severity of the injury, the extent of damage, the likelihood of success of the limb salvage procedure, and the patient’s overall health and goals.

Typically, if the limb is salvageable in the opinion of expert medical professionals, then an amputation is not a medically necessary surgical procedure and is considered a last resort after exploring every other avenue. The question of limb salvage vs amputation will generally only arise if the patient is experiencing severe and distressing pain and symptoms from their injury and instead elect for amputation in hopes of reducing their pain and improving their quality of life.

When a patient is contemplating their limb salvage and amputation options, it is vital that they consult with a team of healthcare professionals, including surgeons, rehabilitation specialists, and mental health professionals, as both options can have significant physical and emotional implications for the patient.

What is lower limb salvage?

Lower limb salvage involves exploring options and alternatives to an elective amputation. A consultant led multi-disciplinary team will work with the injured person to put in place a proactive rehabilitation strategy to try to put the injured person in a position where an elective amputation is avoided where possible.

Limb salvage procedures may include vascular repair, nerve repair, bone grafting, soft tissue reconstruction, and skin grafting. These surgical techniques aim to restore the function and appearance of the limb and may involve protracted surgery, a lengthy recovery period and ongoing rehabilitation.

Though lower limb salvage is not guaranteed to work, the important thing to remember is that there is no such thing as failed limb salvage – no rehabilitation is wasted rehabilitation. The rehabilitation given as part of the limb salvage procedure will often mean that the injured person is stronger, fitter, and more mentally prepared if elective amputation is decided upon.

The process referred to by healthcare professionals as “prehabilitation”, is a term used to describe rehabilitation prior to surgery in order to maximise outcomes both pre-and post-surgery, with the aim of minimising pain and maximising physical ability and potentially mental health. The focus of prehabilitation is on the wider global health of the patient, rather than just focusing on the injured body part. Key to the success of prehabilitation is the timing, location, and clinical expertise of the interdisciplinary team who all input to achieve the best outcomes.

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The prehabilitation treatment is best delivered in a place where the client’s support network is based, and important discussions can take place between all parties to ensure the goals of the client are considered when delivering the prehabilitation.

What is an elective amputation?

Elective amputation is when a person with a severely injured limb chooses to undergo amputation, even if it is not medically necessary to save their life or prevent further harm. This decision is typically made after careful consideration of the risks and benefits of limb salvage versus amputation, and with the guidance and support of a team of medical and mental health professionals.

The decision to undergo elective amputation may be motivated by a desire to regain mobility, function and independence, reduce chronic pain, or improve quality of life. In some cases, it may also be related to psychological factors such as a desire to regain control or cope with trauma. It is important to note that elective amputation is not a decision to be taken lightly and should only be considered after all other treatment options have been exhausted.

Choosing an elective amputation after an accident is a highly personal decision that requires careful consideration and support from healthcare professionals. It is important that patients considering elective amputation have access to comprehensive pre- and post-operative care, including rehabilitation, psychological support, and long-term medical management.

Mental well-being

Both elective amputation and limb salvage can have significant physical and emotional implications for the patient. As such, it is important that anyone considering these options undergo a thorough assessment of their mental well-being to ensure they are making an informed decision, and that they have the necessary support to cope with the potential challenges ahead. Psychological support can help with pain psychology, adjustment disorder, PTSD, and secondary depression, all of which can be managed alongside physical rehabilitation.

Particularly with elective amputations, mental health professionals will evaluate the patient’s emotional state, coping skills, support system, and ability to make informed decisions. Typically, patients will have tried various other avenues before elective amputation, including limb salvage, and this should mean the patient is in the best mental and physical condition to have an amputation and adapt to life as an amputee due to the rehabilitation they will have already gone through.

Psychologists will also evaluate the patient’s understanding of the potential risks and benefits of elective amputation and their ability to manage the physical and emotional challenges that may arise after the procedure. As an example, many patients who have undergone elective amputation have reported they suffered an extreme grief reaction to losing their limb, even though they made the decision to have the surgery and were as prepared as they could be.

If the mental health professional identifies any concerns, they may recommend further evaluation or treatment to address these issues before proceeding with elective amputation. This may include counselling, medication management, or other forms of therapy.

How is compensation affected by elective amputation vs limb salvage?

In terms of compensation for the injury suffered, this will depend whether the injury falls short of amputation but is still extremely serious and leaves the injured person little better off than if the limb had been lost.   However, amputations typically attract higher awards of compensation.

In terms of compensation for the losses or expenses arising out of elective amputation or limb salvage, this will depend on the functional impact of the injury and future needs for example, aids and equipment, accommodation, prosthetic requirements, etc.  Future financial losses and expenses tend to be higher in amputation cases.

How can Major Trauma Group assist?

If you have suffered a severe injury as the result of someone else’s negligence, major Trauma Group can help. Our member firms are highly experienced in assisting clients with their personal injury claims and can assist in complex cases surrounding elective amputations and limb salvaging treatments.

Our expert lawyers can assist you with discussions surrounding limb salvage vs amputations and can offer their services on a no win no fee basis, meaning you do not have to worry about the legal costs when making a claim. Please get in touch with us today to find out more at hello@majortraumagroup.co.uk.

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