An amputation is performed in a hospital’s operating room by a general or orthopedic surgeon. Regional or general anesthesia is used. Antibiotics may be administered as well before surgery. Amputation of a lower limb usually requires hospitalization for several days, but less extensive surgery such as toe amputation might not require an overnight stay.

The surgery has two goals:

• To remove the unhealthy tissue
  
  
• To create a cone-shaped stump that will heal and accept an artificial limb (for more extensive amputations)

Surgical procedures vary according to the type of amputation. A general description of what may take place during an amputation of the lower extremity includes:

• Tourniquets may be used to reduce bleeding but might be avoided with patients who have impaired circulation.
  
  
• The site of incision is cleaned with antiseptic. 
  
  
• Generally the preferred site for amputation is at a joint to avoid the added complication of cutting a bone in half.
  
  
• The incision is made through the skin. Two flaps of skin and underlying tissue are created. As much skin as possible is kept and will be used later in the surgery to cover the stump. The muscle is cut, and the blood vessels are exposed.
  
  
• The main arteries and veins are cut. They are reconnected to restore circulation.
  
  
• The nerves are pulled down, tied above the site of amputation and cut. Severing them above the amputation site helps keep the patient from later experiencing pain in the stump (phantom limb pain).
  
  
• If bone is to be bisected, it is cut with a surgical saw. Bony prominences near the amputation site are filed.
  
  
• Muscle is extended over the amputation site and sutured over bone. The skin flaps are gathered over the site and sewed together.
  
  
• Sterile wound dressings are applied. These will be changed frequently during recovery. In some cases a rigid dressing, splint or cast is applied at the end of the surgery. These may be removed within a week or two. The stitches may be removed after two to four weeks.
  
  
• The patient is wheeled into a surgery recovery room for monitoring while the anesthetic wears off. Medications such as antibiotics and painkillers may be given.