Leg or foot amputation - dressing change

Gather the supplies you will need to change your dressing, and place them on a clean work area. You will need:

• Paper tape
• Scissors
• Gauze pads or clean wash cloths to clean and dry your wound
• ADAPTIC dressing or other dressing product that does not stick to the wound
• 4-inch by 4-inch (10 cm by 10 cm) gauze pad, or 5-inch by 9-inch (13 cm by 23cm) abdominal dressing pad (ABD)
• Gauze wraps or Kling roll
• Plastic bag
• A basin for water and soap to clean your hands while changing the dressings

Take off your old dressing only if your health care provider tells you to. Wash your hands with soap and warm water. Rinse with warm water and dry with a clean towel.

Remove the elastic bandages from the stump, and set them aside. Put a clean towel under your leg before you take the old dressing off. Remove the tape. Unwind the outer wrap, or cut off the outer dressing with clean scissors.

Gently remove the dressing from the wound. If the dressing is stuck, wet it with warm tap water, wait 3 to 5 minutes for it to loosen, and remove it. Place the old dressing in the plastic bag.

Wash your hands again. Use soap and water on a gauze pad or a clean cloth to wash your wound. Start at one end of the wound and clean it to the other end. Be sure to wash away any drainage or dried blood. Do not scrub the wound hard.

Pat the wound gently with a dry gauze pad or a clean towel to dry it from one end to the other. Inspect the wound for redness, drainage, or swelling.

Cover the wound with the dressing. Put on the ADAPTIC (non-stick) dressing first. Then follow with a gauze pad or ABD pad. Wrap with the gauze or Kling roll to hold the dressing in place. Put the dressing on lightly. Putting it on tightly can decrease blood flow to your wound and slow healing.

Tape the end of the dressing to hold it in place. Be sure to tape onto the dressing and not onto the skin. Put the elastic bandage on around the stump. At times, your doctor may want you to wear a stump sock. Please put them on as instructed even though it can be uncomfortable initially.

Clean up the work area and place the old dressing in the trash. Wash your hands.

Contact your provider if:

• Your stump looks redder, or there are red streaks on your skin going up your leg.
• Your skin feels warmer to touch.
• There is swelling or bulging around the wound.
• There is new drainage or bleeding from the wound.
• There are new openings in the wound or the skin around the wound is pulling away.
• Your temperature is above 101.5°F (38.6°C) more than one time.
• The skin around the stump or wound is dark or turning black.
• Your pain is worse, and your pain medicines are not controlling it.
• Your wound has gotten larger.
• A foul smell is coming from your wound.

American Association for the Surgery of Trauma website. Nagy K. Discharge instructions for wound cares. www.aast.org/resources-detail/discharge-instructions-wound-cares. Updated August 2013. Accessed July 5, 2024.

Ford MC. Amputations of the lower extremity. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 16.

Toy PC. General principles of amputations. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 14.

US Department of Veterans Affairs website. VA/DoD clinical practice guideline: rehabilitation of lower limb amputation (2017). www.healthquality.va.gov/guidelines/Rehab/amp. Accessed July 5, 2024.

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.