The psychologic assessment and psychosocial recovery of the patient with an amputation.
The purpose of this paper is to introduce the surgical clinician to the importance of psychosocial issues in those patients undergoing amputation. Although fundamental, obtaining a good recovery for the patient means far more than providing a technically superb surgical outcome. This paper reviews the necessity of a thorough preoperative assessment in those psychosocial areas most likely to impact how the patient perceives, reacts to, and, ultimately, accepts the recommendation for amputation. Patients who undergo amputations as a result of chronic illness, of trauma, or of cancer have common concerns and special vulnerabilities that the astute surgeon should recognize. After reading this paper, the clinician should know how to assess patients in many dimensions, how to formulate a comprehensive treatment plan for psychosocial recovery, to be familiar with and to appreciate expected emotional responses in their patients, and to look for and recognize complications and stress points that require interventions either from the clinician or via a consultation. The referring surgeon should be familiar with the aims of psychotherapeutic treatment modalities and be comfortable in asking the goals and progress being made by their patients. They should have continuing input and receive timely updates.