title: Post-amputation rehabilitation in an emergency crisis: from preoperative to the community.
abstract: OBJECTIVE
  Losing a limb (or a part of a limb) usually leads to loss of functionality and subsequent disability. This paper aims at pointing out the importance of comprehensive and multidisciplinary care that includes early, direct or indirect, involvement of rehabilitation service providers even in an emergency context.
  
  
  METHODS
  We underline the links between amputation and disability as well as the milestones and main purposes of the rehabilitation process following amputation. We then emphasise the influence that the level of amputation has on functional outcomes.
  
  
  RESULTS
  In order for functional outcomes to balance purely medical factors when identifying the best site for amputation in emergency settings where preoperative involvement of a rehabilitation professional is difficult due to limited resources, we enunciate five general rules to be used as guidelines by the medical team in the absence of a rehabilitation service provider. These five rules, remaining general enough to apply to most contexts and patients, still need to be balanced against contextual and personal factors that can only be identified at the time of the amputation.
  
  
  CONCLUSIONS
  The main expectations of people who undergo surgery are, usually, to remain actors in the society and regain functional abilities. Therefore, surgical outcomes are closely related to functional outcomes. In order for the functional and personal factors to be taken into account, we recommend, even in an emergency context, preoperative involvement of rehabilitation care providers.
authors.affiliation: Handicap International, Brussels, Belgium. didierd@handicap.be
authors.forename: Didier
authors.initials: D
authors.lastname: Demey
mesh_terms: D000203:Activities of Daily Living; D000671:Amputation, Surgical / Q000523:psychology / Q000534:rehabilitation*; D000674:Amputees / Q000523:psychology / Q000534:rehabilitation*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D004185:Disability Evaluation; D004635:Emergency Medicine / Q000379:methods*; D005121:Extremities / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D010348:Patient Care Team; D011300:Preoperative Care / Q000379:methods*; D057234:Preoperative Period; D020127:Recovery of Function; D016896:Treatment Outcome