Transmetatarsal Amputation (TMA)
This handout will tell you how to take care of yourself at home after your transmetatarsal amputation (TMA). Before you leave the hospital, your nurse will review this handout with you and answer any questions you might have. If you have any questions when you are home, you may call the PVS clinic at (608) 263-8915. If you need to reach a doctor after hours, you may do so by calling hospital paging at (608) 262-0486. Ask for the PVS resident on call. Give the paging service your name and phone number with area code. The doctor will call you back. If you live out of the area, please call 1-800-323-8942.
Care of the Incision
When you leave the hospital, your incision is most often closed with stitches or staples. These will be removed by your doctor at a follow-up visit. Your incision may be washed with mild soap and warm water. Use a mild, fragrance-free soap. Deodorant soaps can dry out the skin. Wash it gently with a clean washcloth or gauze but do not scrub. Rinse thoroughly and dry gently. Allow the incision and surrounding skin to dry completely before applying the dressing. For dry skin, apply a moisturizing cream once or twice a day.
Do not soak in a tub. Do not use any lotions, alcohol, powders, or oils on your incision, unless directed by your doctor.
When to Call Your Doctor
Twice each day you should look at your amputation site for signs of infection or breakdown. Please call your doctor if you have:
1. An increase in redness or warmth at the amputation site or red streaks on your skin that extend from the site where the stitches are.
2. Bulging, swelling, or red streaks at the incision.
3. New drainage or bleeding from your incision, or open spots between the stitches where the skin is pulling apart.
4. A temperature of more than 101.5°F (38.5°C) by mouth for two readings taken 4 hours apart.
5. If you notice the skin along the incision is getting darker or turning black.
Care of the Foot
1. Look at the entire foot daily. Make sure you look at the back as well as the front. Look for skin abrasions, cracks, sores, blisters, rashes, and redness. Use a mirror if necessary.
2. Wash your foot everyday following the instructions above.
3. Wrap your foot loosely with dry gauze unless otherwise instructed by your doctor.
4. Change your dressing:
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Pain Control
It is normal to have some pain at the suture line and in your foot after surgery.. Your doctor has prescribed pain medicine for you to use at home. This is often the same medicine that you have been getting here. As healing occurs, comfort along the incision improves and you will need less for pain. Your pain may be relieved with an over-the-counter pain reliever. Consult your doctor before starting.
Diet
It is common after this type of surgery to have a decreased appetite and some weight loss. Even if your appetite is poor, you should try to eat well to promote healing. Many times small amounts of food eaten often work better than three large meals a day.
The number one problem patients have after going home is not getting enough fluids. This can increase your fatigue and weakness and slow your healing. It is very important to follow the guidelines below.
1. Drink at least 8-10 (8 oz.) glasses of water or fruit juice per day. Caffeine-containing drinks deplete your body of fluids and are not the best choice for meeting your fluid needs.
2. Eat at least 3 fiber-rich foods each day. Food rich in fiber include most fruits and vegetables (especially apples, dates, beans and peas) and whole grain breads and cereals (especially bran products and oatmeal).
3. Try eating prunes or dinking prune juice.
Activity
After surgery you may notice that you tire more easily when you do things. This is normal and will decrease as you get your strength and energy back. Activity will help you become stronger as well as help prevent constipation. Remember that it is important to be as active as possible but also allow for periods of rest. When sitting in a chair or in bed, keep your legs elevated. When walking you should use a heel weight-bearing shoe and start slowly. You may also want to get a "toe filler" once healed. Slowly increase the amount of activity you do each day.
Are You at Risk for Poor Blood Flow to the Legs and Feet?
You are more likely to have poor blood flow to the legs if you:
- Smoke
- Are over age 50
- Have high blood pressure
- Have high cholesterol
- Have diabetes
- Do not exercise
- Have heart disease in your family
How Do I Take Care of Legs and Feet with Poor Blood Flow?
- Look at legs and feet daily for sores, scratches, cracks, blisters, or reddened areas. Report them to your doctor or nurse.
- Wash your legs and feet daily with mild soap and water. Avoid soaking. Dry well.
- Put lotion on dry skin daily.
- Let a doctor or nurse clip your toenails or show you how to clip them.
- Wear shoes that fit well.
- Wear white cotton or wool socks.
- Check shoes and socks for stones, sharp things, or holes.
- Do not use heating pads or hot water bottles on legs or feet.
- Never go barefoot.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 02/19/2013
Copyright © 02/19/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4892
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