Transmetatarsal Amputation (TMA) and Toe Amputation

Transmetatarsal amputation (TMA) is a surgery to remove part of your foot. You may need a TMA if you have poor blood flow to your foot or a severe infection.

A toe amputation is a surgery to remove one or more toes.

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 provider at a follow-up visit. Wash your incision with soap and warm water every day. Use a mild, fragrance-free soap. Wash it gently with a clean washcloth or gauze but do not scrub. Rinse well and dry gently. Allow the incision and skin around it to dry completely before putting on the dressing. Wrap the foot loosely with dry gauze unless your provider gave you other directions.

Do not soak in a tub, swimming pool, or hot tub. Do not use any lotions, alcohol, powders, or oils on your incision.

Pain Control

It is normal to have some pain at the suture line and in your foot after surgery. Your provider has prescribed pain medicine for you to use at home. This is often the same medicine that you have been getting in the hospital. As healing occurs, your pain will improve and you will need less pain medicine. Ask your provider what over-the-counter medicine is safe for you to take.

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. Eating small meals more often may be better than eating three large meals a day.

The number one problem patients have after going home is not getting enough fluids. This can make you feel tired and weak and slow your healing. It is very important to follow the guidelines below.

Drink at least 8-10 (8 oz.) glasses of water or juice per day. Avoid drinks with caffeine. Caffeine causes your body to lose more fluid.

Eat at least 3 fiber-rich foods each day. Food rich in fiber include most fruits and vegetables (such as apples, dates, beans and peas, prunes and prune juice) and whole grain breads and cereals (such as bran products and oatmeal).

Activity

After surgery you may notice that you tire more easily. This is normal and will improve as you get your strength and energy back. Staying active will help you gain strength and will help prevent constipation. You should be as active as you can but also take time to rest. Slowly increase the amount of activity you do each day.

When sitting in a chair or in bed, keep your legs elevated. When walking, follow the instructions from your provider. Sometimes you can use a heel weight bearing shoe. Sometimes, you may not put any weight on your foot.

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
  

Taking Care of Legs and Feet with Poor Blood Flow

• Look at legs and feet daily for sores, scratches, cracks, blisters, and redness. Report them to your provider 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 provider 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.
  

When to Call

You should look at your amputation site every day. Please call your provider if you have:

• An increase in redness or warmth at the amputation site.

• Red streaks on your skin that extend from the site where the stitches are.

• Bulging or swelling at the incision.

• New drainage or bleeding from your incision.

• Open spots between the stitches where the skin is pulling apart.

• A fever higher than 101.5°F (38.5°C) by mouth for two readings taken 4 hours apart.

• If you notice the skin along the incision is getting darker or turning black.
  

Who to Call

Vascular Surgery Clinic
8:00 am to 5:00 pm Monday through Friday (608) 263-8915

After hours call: (608) 263-6400. Ask for the vascular surgery provider on call. Give the your name and phone number with area code. The provider will call you back.

Toll-free- 1-800-323-8942.